Anderson S G, Rodin J, Ariyan S
Department of Psychology, Veteran Administration Medical Center, Palo Alto, CA.
Ann Plast Surg. 1994 Sep;33(3):263-70; discussion 270-1. doi: 10.1097/00000637-199409000-00006.
Although studies concerning motivation for and satisfaction with breast reconstruction after mastectomy have proliferated, little information is available concerning the relative importance of motivating factors and satisfaction with treatment choice in nonreconstructed and reconstructed mastectomy patients. We studied this by questioning 144 women in four groups: mastectomy patients who had reconstruction; mastectomy patients who did not have reconstruction; and two control groups composed of women who had not had any cancer or who had undergone hysterectomy for uterine cancer. This study was conducted just before the reports of alleged risks of silicone to the patients and reflects the opinions of patients without such bias. This study shows that, although women who opted for reconstruction reported greater concern about appearance than women who did not have reconstruction, both groups described concerns about surgical discomfort and possible complications. Also, women's concerns about appearance did not seem to fall solely into public (others' evaluations) or private (patients' own evaluation) domains. Rather, personal attitudes about appearance may affect interpersonal experiences. Finally, concerns about the possibility of recurrence may reduce patient satisfaction for some women who have reconstruction, so postsurgical education regarding cancer risk may be needed. Reconstructed and nonreconstructed mastectomy patients do not appear to differ in postoperative behaviors promoting personal health. This information, analyzed before the silicone controversy, may serve as a baseline for future research on the impact of the silicone crisis on women's perceptions regarding reconstruction.
尽管关于乳房切除术后乳房重建的动机和满意度的研究大量涌现，但对于未进行重建和已进行重建的乳房切除患者而言，关于动机因素的相对重要性以及对治疗选择的满意度，几乎没有相关信息。我们通过对四组共144名女性进行询问来研究这一问题：进行了乳房重建的乳房切除患者；未进行乳房重建的乳房切除患者；以及两个对照组，一组由未患任何癌症的女性组成，另一组由因子宫癌接受子宫切除术的女性组成。这项研究是在向患者报告所谓的硅胶风险之前进行的，反映了没有此类偏见的患者的意见。这项研究表明，尽管选择进行重建的女性比未进行重建的女性报告了对外观更大的担忧，但两组都描述了对手术不适和可能并发症的担忧。此外，女性对外观的担忧似乎并不完全局限于公众（他人的评价）或私人（患者自己的评价）领域。相反，个人对外观的态度可能会影响人际体验。最后，对复发可能性的担忧可能会降低一些进行了重建的女性的患者满意度，因此可能需要进行关于癌症风险的术后教育。进行了重建和未进行重建的乳房切除患者在促进个人健康的术后行为方面似乎没有差异。这些在硅胶争议之前分析的信息，可作为未来研究硅胶危机对女性关于重建的认知影响的基线。
