Departamento de Ginecologia e Obstetricia, Universidade do Vale do Sapucai, Pouso Alegre, MG, BR.
Programa de Pos-graduacao em Cirurgia Translacional, Departamento de Cirurgia, Universidade Federal de Sao Paulo, Sao Paulo, SP, BR.
Clinics (Sao Paulo). 2019 May 30;74:e883. doi: 10.6061/clinics/2019/e883.
To evaluate the impact of breast reconstruction after mastectomy on sexual function, body image, and depression.
This cross-sectional, comparative, controlled study was conducted with 90 women between 18 and 65 years of age who had undergone either mastectomy alone (mastectomy group, n=30) or mastectomy combined with breast reconstruction (mastectomy-reconstruction group, n=30) at least one year prior to the study or who had no breast cancer (control group, n=30). Patients were assessed for sexual function, depression, and body image using the validated Brazilian-Portuguese versions of the Female Sexual Function Index, the Beck Depression Inventory, and the Body Dysmorphic Disorder Examination, respectively.
The three groups were homogeneous for age, marital status, body mass index, and education level. The women in the mastectomy group reported significantly worse sexual function, greater depressive symptoms, and lower body image than those in the mastectomy-reconstruction and control groups. In the mastectomy group, the frequency of sexual dysfunction was significantly greater among patients without a marital partner and those with a higher level of education than among patients in the other two groups with the same characteristics.
Patients who had undergone breast reconstruction after mastectomy reported better sexual function and body image and fewer depressive symptoms than patients who had undergone mastectomy alone. Sexual dysfunction was associated with the absence of a marital partner and a higher level of education and was more frequent in the mastectomy group.
评估乳房重建对乳腺癌患者术后性功能、身体形象和抑郁的影响。
本横断面、对照、对照研究纳入了 90 名年龄在 18 至 65 岁之间的女性，这些女性均在研究前至少一年接受过单纯乳房切除术（乳房切除术组，n=30）或乳房切除术联合乳房重建（乳房切除术-重建组，n=30），或未患有乳腺癌（对照组，n=30）。使用经巴西葡萄牙语验证的女性性功能指数、贝克抑郁量表和身体畸形障碍检查表，分别评估患者的性功能、抑郁和身体形象。
三组在年龄、婚姻状况、体重指数和教育水平方面均具有同质性。乳房切除术组患者的性功能明显更差，抑郁症状更严重，身体形象更低，与乳房切除术-重建组和对照组相比。在乳房切除术组中，与其他两组具有相同特征的患者相比，无婚姻伴侣的患者和受教育程度较高的患者发生性功能障碍的频率显著更高。
与单纯乳房切除术相比，接受乳房重建的患者术后性功能和身体形象更好，抑郁症状更少。性功能障碍与无婚姻伴侣和较高的教育程度有关，且在乳房切除术组更为常见。
