Breast Cancer Patients Often Mispredict Well-Being

Feb 10, 2018
Breast Cancer Patients Often Mispredict Well-Being After Mastectomy

Bottom Line: Women with breast cancer who underwent a mastectomy without breast reconstruction generally underestimated their future quality of life, while those who had immediate reconstruction generally overestimated it.

Why The Research Is Interesting: Making an informed decision about breast reconstruction requires predicting how one would feel after the procedure. As more women undergo mastectomy, how well they make these predictions becomes increasingly important.

Who and When: 96 women with breast cancer who underwent a mastectomy and were surveyed before and after surgery from July 2012 to February 2014.

What (Study Measures): Mastectomy only or mastectomy with immediate reconstruction (exposures); preoperative predicted measures after one year of happiness, quality of life, satisfaction with breasts, sexual attractiveness, and breast numbness and pain (measures).

How (Study Design): This was an observational study. Researchers were not intervening for purposes of the study and cannot control all the natural differences that could explain the study findings.

Authors: Clara Nan-hi Lee, M.D., M.P.P., Ohio State University, Columbus, and coauthors

Results:
In this cohort of 96 patients, those undergoing mastectomy without reconstruction underestimated their future quality of life and satisfaction with their clothed breasts, and those undergoing mastectomy with reconstruction overestimated their satisfaction with their unclothed breasts, unclothed sexual attractiveness and clothed sexual attractiveness. Misprediction was associated with greater regret in both groups.

Study Conclusions: Breast cancer patients underestimated future well-being after mastectomy and overestimated well-being after reconstruction. Decision support for breast reconstruction should address expectations about well-being.

For more details and to read the full study, please visit the For The Media website.

(doi:10.1001/jamasurg.2017.6112)