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As breast reconstruction is an important adjunct after mastectomy to regain physical integrity and also to improve affect, the present aim was to evaluate patients' subjective perceptions of body image during the whole breast reconstruction period and to assess the importance of their psychological reaction in terms of negative affectivity. Participants were 62 women, 43 women (M age = 46.4, SD = 9.8) who had had mastectomies and 19 healthy women (M age = 39.9, SD = 13.99). Patients were admitted for surgery at the Hospital S. Orsola in Bologna. Healthy subjects were relatives of the women and students, all with no history of breast pathology. The Body Satisfaction Scale and the State Anxiety Inventory-Y were administered to the two groups before, post, and 6 too. after surgery. Analysis of scores indicated that during the period of the study, the women with mastectomies reported higher anxiety and also greater dissatisfaction with their body image than the healthy group, even when the breast had been reconstructed. This unexpected finding suggests patients' unrealistic expectations of the breast reconstruction and the surgical outcome.

While data are accumulating on the efficacy of prophylactic mastectomy as a means to reduce breast cancer risk in high risk women, the effectiveness of the procedure depends on women's interest in undergoing the procedure. We report on women's responses to this surgical option as a prevention tool. Data derive from a multi-method study of women's interest in and understandings about genetic testing for breast cancer susceptibility. The sample comprises 246 women of varying ethnicities and familial breast cancer risk from Seattle, USA. In this paper, quantitative data are presented on the sociodemographic and risk perception correlates of degree of interest in taking a genetic test for breast cancer if prophylactic mastectomy were the only treatment option. In addition, we report results of a content analysis of women's open-ended responses to the question of whether and why they could imagine undergoing prophylactic mastectomy. Our analysis of these data benefits from a central distinction in medical anthropology between the concepts of illness and disease. We suggest that while prophylactic mastectomy may prevent the 'disease' of breast cancer, it may be of little interest to women who see this surgery as itself mimicking the 'illness' of breast cancer. Keywords: Prophylactic mastectomy; Breast cancer; Disease and illness; Genetic susceptibility; USA

The main purpose was to offer evidence for the hypothesis that the stronger an acute real life stressor, namely, hearing from the physician that one has breast cancer and that one has to undergo mastectomy, the greater the induced noradrenaline (NA) depletion in the central nervous system (CNS) and the more the patient loses hope to recover. The data were derived from answers to interviews, questionnaires, and analyses of blood samples obtained from the patients on the day of admission to the hospital for a biopsy and 24 hours after the surgeon communicated the results of the biopsy to the patients. Analysis showed that a decline in 3-Methoxy 4-Hydroxy Methoxy 4-Hydroxy Phenylethylene Glycol (MHPG) concentration in blood plasma samples after being informed of the diagnosis is associated with less hope of recovery. MHPG is the main metabolite of CNS noradrenaline.

Education concerning breast reconstruction is vital to the well-being of women who have had mastectomies and their partners. Research indicates that patient education can positively affect patient decision-making and self-care. The staff of Memorial Sloan-Kettering hospital in New York, NY have organized classes for patients considering reconstructive surgery and their spouses or partners. The classes address questions concerning surgical options, self-care, complications, and sexuality.

Following a mastectomy, women can choose breast reconstruction through tissue expansion as an alternative to muscle flap surgery. The procedure involves stretching the skin with an inflatable expander, and though it is less predictable and offers some disadvantages, it is also less complicated and invasive than other procedures. Post operative care following the procedure is critical.

A study examining self-esteem, anxiety, depression, and coping skills in 21 Caucasian women who underwent breast reconstruction following a mastectomy found the women functioning at normal levels and coping in a positive manner. The study incorporated well-researched and reliable assessment tools and involved women aged 28 to 64. The small investigation confirmed the belief that reconstructive surgery helps alleviate depression, improves self-esteem, and reduces cancer anxiety.

The latissmus dorsi flap procedure in breast reconstruction is simple and allows for generous covering of muscle and tissue loss. The latissmus dorsi muscle is located in the lumbar and sacral vertebrae area and can cover a 15 x 12 cm area. The flap is surgically rotated into place on the breast area and a breast mound is constructed. Postoperative care requires strict monitoring of circulation, wound drainage, and physical activity.

The transverse rectus abdominis myocutaneous (TRAM) flap procedure replaces a woman's breast tissue with her abdominal tissue following breast surgery. The procedure is recommended because it does not require an implant, the size and shape of the breast can be adjusted, and it works well in difficult surgical cases. Problems with the technique include loss of skin and muscle, hernia, longer hospitalization and outpatient care. Breast reconstruction following a mastectomy is psychologically beneficial to patients and does not complicate oncological care.

Women who have undergone mastectomies and are considering breast reconstruction face many physical and psychological challenges. A positive self image and a strong support network can help a woman choose whether or not to have reconstructive surgery and to cope with the stress following reconstructive surgery. The modern mastectomy patient has several reconstructive procedures to choose from, including TRAM flap surgery and tissue expansion. The physician and nurse must be able to ease the patient's anxiety and educate her about the reconstructive process.

Nipple and areolar reconstruction are the final steps in breast reconstruction surgery following a mastectomy. Although patients are often frustrated by the many surgeries they have undergone, the final procedures are simple and can provide patients a more natural looking breast and benefit the patient psychologically. The procedure can be performed under local or no anesthesia and the patient is encouraged to participate in deciding nipple location and areola pigment.

This study explored the effects of mastectomy for breast cancer on individual and marital adjustment. Subjects consisted of 20 spouse pairs in which the wife had single mastectomy for Stage I/II breast cancer 2.5 years prior to testing. Each spouse completed paper-and-pencil inventories measuring individual psychological adjustment and marital adjustment. Results indicate that both husbands and wives had adapted to mastectomy and were functioning well as individuals. In contrast, measures of marital adjustment indicated serious problems with extremes of cohesion and adaptability, suggesting psychological fusion and fluidity of reactions. Low levels of consensus suggest a mechanism for maintaining balance and counteracting pathogenic processes in the marital relation.

Byline: Ramesh, Nootan. Shukla, Sushma. Bhatnagar Phantom breast syndrome is a type of condition in which patients have a sensation of residual breast tissue and can include both non-painful sensations [...]

Women diagnosed and surgically treated for regional breast cancer (N = 190) were studied to determine the sexual and body change sequelae for women receiving modified radical mastectomy (MRM) with breast reconstruction in comparison with the sequelae for women receiving breast-conserving therapy (BCT) or MRM without breast reconstruction. The sexuality pattern for women receiving reconstructive surgery was one that was significantly different--with lower rates of activity and fewer signs of sexual responsiveness--than that for women in either of the other groups. Significantly higher levels of traumatic stress and situational distress regarding the breast changes were reported by the women receiving an MRM in contrast to the women treated with BCT. Using a model to predict sexual morbidity, regression analyses revealed that individual differences in sexual self-schema were related to both sexual and body change stress outcomes.

Many women who have a prophylactic mastectomy are able to adjust and have no serious psychological or emotional aftereffects. Women at high risk of breast cancer are often given a mastectomy to prevent the cancer from developing. Although it is potentially devastating to lose a healthy breast, a survey of 572 women who had both breasts removed showed that most were satisfied. The loss of both breasts did not adversely affect their emotional stability, self-esteem, stress levels, sexual relationships, or femininity. However, one-fourth to one-third were dissatisfied with their sexual relationships and body image.

Tamoxifen and raloxifene may prevent breast cancer in healthy women at increased risk for the disease. Women with significant breast cancer risk factors, such as a strong family history of the disease, may benefit from preventive drug therapy. Tamoxifen has already been demonstrated to reduce the risk of the cancer in healthy women, and additional research will compare it with raloxifene. Some women at especially high risk for breast cancer have undergone mastectomy to remove the breast tissue at risk for developing cancer. Most of these women report satisfaction with the radical procedure.

Wortman and Dunkel-Schetter [1] (J. Soc. Issues 35, 120-155, 1979) have argued that victims of misfortune are likely to experience reduced social support at a time when support is needed most. The resulting self-doubt and isolation are thought to increase the victims' distress. Hypotheses derived from their analysis were tested by administering social and emotional adjustment inventories to 301 women who had undergone a mastectomy as treatment for breast cancer, and to 100 women diagnosed as having benign breast lumps (no-cancer, no-mastectomy controls). As expected, perceived emotional support was positively correlated with adjustment. However, contrary to Wortman and Dunkel-Schetter's analysis, the cancer patients perceived greater emotional support from friends and family than did the controls. In addition, these cancer |victims' were no more socially or emotionally maladjusted than women without cancer.

Treatment of the healthy contralateral breast (CB) must be carefully considered during breast reconstruction following a mastectomy. Options concerning CB treatment depend upon the health status of the patient and individual anatomy. Generally, reconstruction options include matching the breast to the CB, reducing the size of the CB, and surgically lifting the CB.

Society regards the female breast as the essence of femininity and female sexuality and so women can be devastated by the loss of a breast. Breast reconstructive surgery after a mastectomy can help restore self-esteem and consequently improve perceptions of body image and sexual relationships. Knowledge of the possibility of breast reconstruction is often vital in helping women cope with the fear and stress of a mastectomy.