Evaluation of awareness, cosmetic and psychological satisfaction following breast oncoplasty among breast cancer patients

Abstract

Background: Breast canceristhe most common cancer amongst women worldwide. Mastectomy leads to a perceived loss of attractiveness and psycho sexual problems. Over the years, increased awareness, improved screening and better therapies have resulted in a considerable decline in mortality, hence women live longer with the physical and psychological trauma of mastectomy. Breast reconstruction is an integral part of breast cancer treatment. However, this is not the case in India where survival itself take precedence over quality of life. Methods: A prospective cohort study was designed including all outpatients and inpa-tients, over 18 years of age, diagnosed with breast cancer who consented to participate in the study. Results: A total of 485 patients were interviewed during the study with a mean age of 47 years, ranging from 18 to 82 years. Amongst these, 26%(126) were illiterate, 55% (266) received minimum secondary level education, only 42 (9%) were working. Majority, 42% (202) of our patients belonged to lower and upper lower socioeconomic status. We found that 15% (71) of our patients were aware about available breast reconstruction options. The most common source of information was the internet. Awareness regarding breast reconstruction was influenced positively by the education status, socio-economic status and profession of the patient (p < 0.01) After thorough counselling, the patients were asked if they would like to opt for reconstruction. A remarkable 49% (239) gave a positive response. A total of 45 breast reconstructions were performed with mean follow up of 15 months. Cosmetic outcome was assessed based on six variables (shape with/without brassiere, symmetry, mobility, consistency, appearance of infra mammary fold). 63% of the patients rated the cosmetic result as excellent. Majority, 68.6% (24), were extremely satisfied with their reconstruction and 51.4% (18) felt a huge positive change in their social life after reconstruction. Conclusions: Breast oncoplasty awareness is poor in India and is affected by literacy, marriage, professional and socioeconomic status. If made aware, patients tend to opt in for breast reconstruction. In skilled hands, this has excellent cosmetic and psychological satisfaction outcome.