Unukovych Dmytro, Wickman Marie, Sandelin Kerstin, Arver Brita, Johansson Hemming, Brandberg Yvonne
Department of Oncology-Pathology, Karolinska Institutet, 171 76 Stockholm, Sweden.
Department of Reconstructive Plastic Surgery, Karolinska University Hospital, 171 76 Stockholm, Sweden; Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 76 Stockholm, Sweden.
Int J Breast Cancer. 2016;2016:4604852. doi: 10.1155/2016/4604852. Epub 2016 May 26.
Introduction. The aim of the study was to investigate associations between reoperations after contralateral risk-reducing mastectomies (CRRM) and emotional problems, body image, sexuality, and health related quality of life (HRQoL) in women with breast cancer and hereditary high risk. Patients and Methods. Patients scheduled for CRRM with breast reconstruction between 1998 and 2010 completed questionnaires, comprised of SF-36, the Hospital Anxiety and Depression Scale, the Body Image Scale, and the Sexual Activity Questionnaire, preoperatively and two years after CRRM. Data on reoperations was collected from medical charts. Results. A total of 80 women participated, with a response rate of 61 (76%) preoperatively and 57 (71%) at the two-year follow-up. At the two-year assessment, 44 (55%) patients had undergone ≥1 reoperation (reoperation group), whereas 36 (45%) had not (no reoperation group). No statistically significant differences between the groups were found for HRQoL, sexuality, anxiety, or depression. A higher proportion of patients in the "reoperation group" reported being dissatisfied with their bodies (81% versus 48%, p = 0.01). Conclusion. The results suggest associations between reoperation following CRRM with breast reconstruction and body image problems. Special attention should be paid to body image problems among women who are subject to reoperations after CRRM.
引言。本研究的目的是调查对侧预防性乳房切除术（CRRM）后再次手术与患有乳腺癌及遗传性高风险的女性的情绪问题、身体意象、性功能和健康相关生活质量（HRQoL）之间的关联。患者与方法。1998年至2010年间计划进行CRRM并乳房重建的患者在术前及CRRM后两年完成了问卷调查，问卷包括SF-36、医院焦虑抑郁量表、身体意象量表和性活动问卷。从病历中收集再次手术的数据。结果。共有80名女性参与，术前回复率为61人（76%），两年随访时为57人（71%）。在两年评估时，44名（55%）患者接受了≥1次再次手术（再次手术组），而36名（45%）患者未接受再次手术（未再次手术组）。两组在HRQoL、性功能、焦虑或抑郁方面未发现统计学上的显著差异。“再次手术组”中较高比例的患者报告对自己的身体不满意（81%对48%，p = 0.01）。结论。结果表明CRRM乳房重建术后再次手术与身体意象问题之间存在关联。对于CRRM后接受再次手术的女性，应特别关注其身体意象问题。
