Breast Reconstruction Satisfaction Among Breast Cancer Patients in Saudi Arabia

Abstract

Background and Aims: Breast cancer patients represent the largest group of cancer survivors. Breast reconstruction post-mastectomy has significantly increased worldwide. The aim of this study is to know the level of satisfaction about breast reconstruction among breast cancer patients. Methods: This cross-sectional study was conducted on women with breast cancer who underwent reconstruction post-mastectomy in a tertiary hospital in Riyadh in the period from January 2013 to August 2018. Satisfaction of patients about reconstruction were collected using (Breast Reconstruction satisfaction questionnaire). Results: A total of 53 participants were considered. 58.4% had a university education or above, and only 32.1% had an income of <5000 SR. No more than 7.5% and 11.3% were unsatisfied and strongly unsatisfied with their self-image. 30.2% were strongly unsatisfied about the discussion with a plastic surgeon prior to reconstruction. 81.1% would recommend the type of reconstruction to a friend, and 77.4% agreed that they would choose this type of reconstruction if they had to do it all over again. 79.2% to 88.7% reported no arm concerns at all. 45.3% of patients reported that it took them longer than expected to recover, and 52.8% of patients reported that the surgery was complex. Patients with above university-level education were significantly more satisfied about their recovery (P≤0.003). Patients whose income was >20000 SR were more satisfied about their recovery (P≤0.029). Patients with higher income were more satisfied about their self-image (P≤0.033). Conclusions: Majority of patients were generally satisfied with their breast reconstruction. However, recovery subscale showed less satisfaction. Also, a relatively high percentage were not satisfied about the discussion with a plastic surgeon prior to the reconstruction. High income and high educational level patients were generally more satisfied.

References

1. 1.World Health Organization https:// www.who.int/cancer/prevention/diagnosis-screening/breast-cancer/en/
2. 2.American Cancer Society. Cancer Facts & Figures 2019-2020 Web site. https:// www.cancer.org/content/dam/cancer-org/ research/cancer-facts-and-statistics/breast- Majmaah Journal of Health Sciences ,Vol. 9, Issue 3, July - 2021, Dhu al-Qi’dah - 1442 39 Breast Reconstruction SatisfactionAmong Breast Cancer Patients in SaudiArabia cancer-facts-and-figures/breast-cancerfacts-and-figures-2019-2020.pdf
3. 3.Mátrai Z, Kenessey I, Sávolt A, Ujhelyi M, Bartal A, Kásler M. Evaluation of patient knowledge, desire, and psychosocial background regarding postmastectomy breast reconstruction in Hungary: a questionnaire study of 500 cases. Med Sci Monit. 2014 Dec 12;20:2633-42.
4. 4.Alghamdi IG, Hussain II, Alghamdi MS, El-Sheemy MA.The incidence rate of female breast cancer in Saudi Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001-2008. Breast Cancer (Dove Med Press). 2013;5:103-109.
5. 5.The Global Cancer Observatory. Published in 2020 Dec. https://gco.iarc.fr/today/data/factsheets/populations/682-saudi-arabia-fact-sheets.pdf
6. 6.Awan BA, Samargandi OA, Alghamdi HA, Sayegh AA, Hakeem YJ, Merdad L, et al. The desire to utilize postmastectomy breast reconstruction in Saudi Arabian women. Predictors and barriers. Saudi Med J. 2015 Mar;36(3):304-9.
7. 7.Jeevan R, Cromwell DA, Browne JP, Trivella M, Pereira J, Caddy CM, et al. Regional variation in use of immediate breast reconstruction after mastectomy for breast cancer in England. Eur J Surg Oncol. 2010 Aug;36(8):750-5.
8. 8.Hvilsom GB, Hölmich LR, Frederiksen K, Steding-Jessen M, Friis S, Dalton SO. Socioeconomic position and breast reconstruction in Danish women. Acta Oncol 2011; 50: 265-273.
9. 9.Karimi N, Descallar J, Girgis A, Soon PS. Breast reconstruction in South Western Sydney. ANZ J Surg. 2020 Nov;90(11):2340-2345.
10. 10.Kruper L, Holt A, Xu XX, Duan L, Henderson K, Bernstein L, et al. Disparities in reconstruction rates after mastectomy: patterns of care and factors associated with the use of breast reconstruction in Southern California. Ann Surg Oncol 2011; 18: 2158-2165.
11. 11.Elmore L, Myckatyn TM, Gao F, Fisher CS, Atkins J, Martin-Dunlap TM, et al. Reconstruction patterns in a single institution cohort of women undergoing mastectomy for breast cancer.Ann Surg Oncol 2012; 19: 3223-3229.
12. 12.Reuben BC, Manwaring J, Neumayer LA. Recent trends and predictors in immediate breast reconstruction after mastectomy in the United States. Am J Surg 2009; 198: 237-243. 13.Awan B, Samargandi O,Aldaqal S,Alharbi A, Alghaithi Z. The attitude and perception of breast reconstruction by general 40 Majmaah Journal of Health Sciences ,Vol. 9, Issue 3, July - 2021, Dhu al-Qi’dah - 1442 Breast Reconstruction SatisfactionAmong Breast Cancer Patients in SaudiArabia surgeons in Saudi Arabia. Ann Saudi Med 2012; 33: 559-565.
13. 13.Brett EA, Aitzetmüller MM, Sauter MA, Huemer GM, Machens HG, Duscher D. Breast cancer recurrence after reconstruction: know thine enemy. Oncotarget. 2018 Jun 12;9(45):27895-27906.
14. 14.Henry M, Baas C, Mathelin C. Why do women refuse reconstructive breast surgery after mastectomy? Gynecol Obstet Fertil. 2010;38(3):217–23.
15. 15.Ng SK, Hare RM, Kuang RJ, Smith KM, Brown BJ, Hunter-Smith DJ. Breast Reconstruction Post Mastectomy: Patient Satisfaction and Decision Making. Ann Plast Surg. 2016 Jun;76(6):640-4.
16. 16.Fanakidou I, Zyga S, Alikari V, Tsironi M, Stathoulis J, Theofilou P. Mental health, loneliness, and illness perception outcomes in quality of life among young breast cancer patients after mastectomy: the role of breast reconstruction. Qual Life Res. 2018 Feb;27(2):539-543.
17. 17.Temple-Oberle CF, Cook EF, Bettger-Hahn M, Mychailyshyn N, Naeem H, Macdermid J. Development of a breast reconstruction satisfaction questionnaire (BRECON-31): principal components analysis and clinimetric properties. J Surg Oncol. 2012 Dec;106(7):799-806.
18. 18.Janz NK, Mujahid M, Lantz PM, Fagerlin A, Salem B, Morrow M, et al. Population-based study of the relationship of treatment and sociodemographics on quality of life for early stage breast cancer. Qual Life Res. 2005 Aug;14(6):1467-79.
19. 19.Arora NK, Gustafson DH, Hawkins RP, McTavish F, Cella DF, Pingree S, et al. Impact of surgery and chemotherapy on the quality of life of younger women with breast carcinoma: a prospective study. Cancer. 2001 Sep 1;92(5):1288-98.
20. 20.Pusic A, Thompson TA, Kerrigan CL, SargeantR,SlezakS,ChangBW,etal.Surgical options for the early-stage breast cancer: factors associated with patient choice and postoperative quality of life. Plast Reconstr Surg. 1999 Oct;104(5):1325-33.
21. 21.Veiga DF, Sabino Neto M, Ferreira LM, Garcia EB,Veiga Filho J, Novo NF, et al. Quality of life outcomes after pedicled TRAM flap delayed breast reconstruction. Br J Plast Surg. 2004 Apr;57(3):252-7.
22. 22.Rubino C, FigusA, Lorettu L, Sechi G. Post-mastectomy reconstruction: a comparative analysis on psychosocial and psychopathological outcomes. J Plast Reconstr Aesthet Surg. 2007;60(5):509–18.
23. 23.Nissen MJ, Swenson KK, Ritz LJ, Farrell JB, Sladek ML, Lally RM. Quality of life after breast carcinoma surgery: a comparison of three surgical procedures. Can- Majmaah Journal of Health Sciences ,Vol. 9, Issue 3, July - 2021, Dhu al-Qi’dah - 1442 41 Breast Reconstruction SatisfactionAmong Breast Cancer Patients in SaudiArabia cer. 2001 Apr 1;91(7):1238-46.
24. 24.Alderman AK, Hawley ST, Waljee J, Mujahid M, Morrow M, Katz SJ. Understanding the impact of breast reconstruction on the surgical decision-making process for breast cancer. Cancer. 2008 Feb 1;112(3):489-94.
25. 25.Morrow M, Mujahid M, Lantz PM, Janz NK, Fagerlin A, Schwartz K, et al. Correlates of breast reconstruction: results from a population-based study. Cancer. 2005 Dec 1;104(11):2340-6.
26. 26.Hidding JT, Beurskens CH, van der Wees PJ, van Laarhoven HW, Nijhuis-van der Sanden MW.Treatment related impairments in arm and shoulder in patients with breast cancer: a systematic review. PLoS One. 2014 May 9;9(5):e96748.
27. 27.Alba B, Schultz B, Qin LA, Cohen D, DelMauro M, Ahn S, et al. Postoperative Upper Extremity Function in Implant and Autologous Breast Reconstruction. J Reconstr Microsurg. 2020 Feb;36(2):151-
28. 28.Weichman KE, Hamill JB, Kim HM, Chen X, Wilkins EG, Pusic AL. Understanding the Recovery Phase of Breast Reconstructions: Patient Reported Outcomes Correlated to Type and Timing of Reconstruction. J Plast Reconstr Aesthet Surg. 2015 Oct;68(10):1370–8.
29. 29.McFadden EM, Lopez-Obregon B, Stone JP, Webb CE, Temple-Oberle CF. Direct-to-implant Breast Reconstruction with Autoderm. Plast Reconstr Surg Glob Open. 2018 Dec 17;6(12):e2027
30. 30.Manne SL, Topham N, Kirstein L, Virtue SM, Brill K, Devine KA, et al. Attitudes and Decisional Conflict Regarding Breast Reconstruction Among Breast Cancer Patients. Cancer Nurs. 2016 Nov/ Dec;39(6):427-436.
31. 31.Levine SM, Levine A, Raghubir J, Levine JP. A 10-year review of breast reconstruction in a university-based public hospital. Ann Plast Surg. 2012 Oct;69(4):376-9.
32. 32.Le NK, Gabrick KS, Chouairi F, Mets EJ, Avraham T, Alperovich M. Impact of socioeconomic status on psychological functioning in survivorship following breast cancer and reconstruction. Breast J. 2020 Sep;26(9):1695-1701.
33. 33.Alderman AK, Hawley ST, Janz NK, Mujahid MS, Morrow M, HamiltonAS, et al. Racial and ethnic disparities in the use of postmastectomy breast reconstruction: results from a populationbased study. J Clin Oncol. 2009 Nov 10;27(32):5325-30.
34. 34.Noyan MA, Sertoz OO, Elbi H, Kayar R, Yilmaz R. Variables affecting patient satisfaction in breast surgery: a 42 Majmaah Journal of Health Sciences ,Vol. 9, Issue 3, July - 2021, Dhu al-Qi’dah - 1442 Breast Reconstruction SatisfactionAmong Breast Cancer Patients in SaudiArabia cross-sectional sample of Turkish women with breast cancer. Int J Psychiatry Med. 2006;36(3):299-313.
35. 35.Christian CK, Niland J, Edge SB, Ottesen RA, Hughes ME, Theriault R, et al. A multi-institutional analysis of the socioeconomic determinants of breast reconstruction: a study of the National Comprehensive Cancer Network. Ann Surg. 2006 Feb;243(2):241-9.