Effect of breast reconstruction on the quality of life and self-esteem of women who undergo mastectomy

Dear Editor:

Recently, Alves et al.¹ published a cross-sectional study evaluating the effect of breast reconstruction on the quality of life and self-esteem of 59 women who underwent mastectomy. The authors observed no significant differences between the evaluated groups at 30 days after surgery, and offered possible explanations for similar outcomes between the groups¹.

However, we believe that some methodological problems may have contributed to the unexpected results of the study, including the small sample size and the random selection of patients. Of note is the selection bias related to the use of questionnaires by the support team, despite the availability of internationally validated instruments. Furthermore, considering the psychological effect of a breast cancer diagnosis and invasive surgery, the effectiveness of psychosocial assessment in the postoperative period is questionable.

In Goiás, a case-control study of 167 women found greater dissatisfaction with body image among breast cancer patients, particularly those who underwent mastectomy. Moreover, self-esteem was negatively affected in women dissatisfied with body image². Despite the methodological differences, this study reinforces the hypothesis that mastectomy without breast reconstruction jeopardizes self-esteem and quality of life in these women³.

Therefore, this letter adds some considerations for critical evaluation of the study by Alves et al.¹, and reinforces the need to understand the psychological process after surgical treatment of breast cancer.

REFERÊNCIAS

• ¹
  Alves VL, Sabino Neto M, Abla LEF, Oliveira CJR, Ferreira LM. Avaliação precoce da qualidade de vida e autoestima de pacientes mastectomizadas submetidas ou não à reconstrução mamária. Rev Bras Cir Plást. 2017;32(2):208-17.
• ²
  Prates ACL, Freitas-Junior R, Prates MFO, Veloso MF, Barros NM. Influence of Body Image in Women Undergoing Treatment for Breast Cancer. Rev Bras Ginecol Obstet. 2017;39(4):175-83.
• ³
  Dauplat J, Kwiatkowski F, Rouanet P, Delay E, Clough K, Verhaeghe JL, et al.; STIC-RMI working group. Quality of life after mastectomy with or without immediate breast reconstruction. Br J Surg. 2017;104(9):1197-206.

Publication Dates

• Publication in this collection
  29 May 2023
• Date of issue
  2017

History

• Received
  03 Aug 2017
• Accepted
  23 Sept 2017