In this thesis the psychological impact of two types of breast reconstruction after prophylactic or therapeutic mastectomy for breast cancer was investigated with a prospective study including 202... Show moreIn this thesis the psychological impact of two types of breast reconstruction after prophylactic or therapeutic mastectomy for breast cancer was investigated with a prospective study including 202 patients from different hospitals in the South-West of the Netherlands between 2007-2012. With semi-structured interviews the motives to opt for breast reconstruction were qualitatively investigated. The impact of breast reconstruction was further investigated with psychological questionnaires from baseline to the end of the breast reconstruction procedure (mean follow-up of 21 months). The psychological outcomes after breast reconstruction that were investigated were: body image, satisfaction with the partner relationship and the sexual relationship, general anxiety and depression, cancer distress, and general mental and physical health. In general, the psychological outcomes after breast reconstruction were acceptable, however a subgroup of women experienced psychological adjustment problems. A percentage of 20-30% remained having problems with changes in their body image and the impact on the intimate partner relationship. Women at risk for psychological adjustment problems were younger women, those with significant cancer distress, women who experienced complications after surgery, particularly if the breast reconstruction failed, and women who underwent bilateral prophylactic mastectomy because of an increased hereditary risk to develop breast cancer. Show less
