It is very nice that breast reconstruction is possible. However, the psychological impact of breast reconstruction after mastectomy is underestimated. More information in advance is therefore an important factor.
That is the opinion of Jessica Gopie in psychology, who obtained her doctorate on 9 January at the Leiden University Medical Center.
Three reconstruction methods
Jessica studied three breast reconstruction methods in multiple hospitals. She surveyed women who had had a breast amputated about the reasons for choosing an implant, reconstruction with a DIEP flap (a reconstruction with a flap of skin) or no reconstruction.
Considerations
Women who opted for reconstruction wanted to feel feminine, they considered themselves too young to continue living without a breast or were afraid of wearing loose prostheses. The reasons for not choosing breast reconstruction were older age, acceptance of missing a breast, fear of complication risks and fear of (even more) operations.
Choice
A large number of women were not aware of the various options and the complication risks in advance. Many women suffered from emotional problems afterwards. 40 percent of the women developed complications, such as wound inflammation or infections. This often caused a temporary increase in emotional problems. A failed reconstruction led to longer-term emotional problems.
Pre-Information
By receiving complete information in advance, women can make a better informed choice about a possible reconstruction and the way in which it will be performed. Sometimes more psychological counseling is also needed.
Difficulty with relationships
There is a lot at stake for women with breast cancer or a hereditary increased risk of it. After a reconstruction, 30 percent continue to struggle with her body image and intimate relationships. Doctors should take this into account, says Jessica Gopie. For example, doctors could show pictures of successful and less successful reconstructions and more complete information should be provided. In addition, more attention should be paid to the mental well-being of women in this situation. For example, through a referral to a psychologist, possibly even before the reconstruction. Women need to know that they are not alone with these problems.
