RESUMO
BACKGROUND: Patients' coping styles, perceptions, and attitudes are important for healthy living and survivorship in breast cancer. AIM: To assess factors associated with coping styles in patients with breast cancer surgery in an underserved population in Northern Nigeria. METHODS: This cross-sectional study included 72 patients with breast cancer post-surgery. Data was collected on clinico-demographic variables, patients' perceptions, the World Health Organization Quality of Life (WHOQOL-BREF), the General Health Questionnaire (GHQ-12), and the Coping Strategy Inventory (CSI-32). RESULTS: The mean age of participants was 45.9 (±9.1) years. Over 80% of participants underwent mastectomy, with 93.1% reporting complications. Notwithstanding, participants largely perceived that the procedure was life-saving, and most did not feel the need for a breast prosthesis. Notably, 70.8% reported an increased tendency to withdraw socially, but only 34.7% experienced functional difficulties with daily activities or chores. Patients practiced different engagement-disengagement coping strategies, albeit use of multiple dimensions of engagement coping was pronounced in a greater fraction (percentile) of patients. Multiple aspects of perception (including a lack of satisfaction with clothes fitting, feelings of incompleteness, greater time since surgery), and the experience of psychological distress were associated with disengagement coping. On the other hand, engagement coping was more likely in patients who were satisfied with clothing fit, experienced less impact on daily living, and had an improved quality of life. CONCLUSION: Coping in patients with breast cancer post-surgery is multifaceted, varying by individual perception and psychosocial wellbeing. Future research is needed to guide interventions that bolster psychosocial well-being to promote healthy coping.
Assuntos
Adaptação Psicológica , Neoplasias da Mama , Mastectomia , Qualidade de Vida , Humanos , Feminino , Neoplasias da Mama/psicologia , Neoplasias da Mama/cirurgia , Nigéria , Pessoa de Meia-Idade , Estudos Transversais , Qualidade de Vida/psicologia , Adulto , Mastectomia/psicologia , Inquéritos e Questionários , Idoso , Percepção , Área Carente de Assistência Médica , Habilidades de EnfrentamentoRESUMO
INTRODUCTION: The continued enforcement of traditional gender roles continues to oppress Arab women. This coupled with the taboo nature of discussing sexual health may contribute to unmet sexual health needs for Arabic women who have had a mastectomy. The aim of this article is to present qualitative findings of Arab women's sexual health experiences following mastectomy. METHOD: This study was underpinned by social constructivism, feminist perspectives, and storytelling. A sample of 22 Arabic women, 28 to 60 years of age, who had a mastectomy were interviewed with data analyzed thematically. RESULTS: Arabic women's self-worth is inextricably linked with being a wife and mother. Participants experienced low self-esteem and feelings of inadequacy after the loss of their breast, which negatively affected their sexual health. DISCUSSION: A woman's journey navigating breast cancer and mastectomy within a patriarchal culture can be detrimental to not only their sexual health but also overall well-being.
Assuntos
Árabes , Feminilidade , Mastectomia , Saúde Sexual , Humanos , Feminino , Pessoa de Meia-Idade , Adulto , Mastectomia/psicologia , Mastectomia/efeitos adversos , Pesquisa Qualitativa , Saúde Sexual/etnologia , Árabes/psicologia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , AutoimagemRESUMO
PURPOSE: Obtaining firsthand insight into breast cancer facilitates a detailed understanding of women with breast cancer' emotional experiences, thereby promotes holistic cancer care. This study aimed to identify the emotions experienced by women undergoing mastectomy during the disease and treatment process. METHODS: This qualitative study, based on a descriptive phenomenological design, was conducted using semi-structured interviews to explore the emotions of women who had undergone mastectomy during the diagnosis and treatment stages. Twenty-nine breast cancer women with breast cancer aged 27-68 who had undergone mastectomy participated in the study, which was carried out in the general surgery clinic of a university hospital. The data obtained from the interviews were subjected to thematic analysis. RESULTS: It was found that women undergoing mastectomy experience a wide range of emotions at all stages of breast cancer and develop corresponding coping strategies. Five themes emerged from the analysis: emotions related to diagnosis, emotions related to treatment, future-oriented emotions, coping strategies, and family and social relationships. Unlike the findings reported in the literature, this study revealed that women often expressed reactions such as "wanting to die" or "not feeling anything" during the diagnosis process. In terms of family relationships, diverse factors such as divorce, spousal psychological violence, spousal support, and physical violence were noted. CONCLUSIONS: Having breast cancer triggers profound emotional fluctuations in women, such as fear, uncertainty, burnout, and disturbances in self-perception. While hope and optimism for the future are fueled by positive emotions such as social support and a desire to see children happy, negative experiences such as cancer stigma and psychological violence increase the emotional burden. Supportive care teams are recommended to enhance psychosocial support services, promote the emotional well-being of women after mastectomy, strengthen family and social participation, develop individualized care plans, and implement holistic approaches through team-based care.
Assuntos
Neoplasias da Mama , Emoções , Mastectomia , Humanos , Feminino , Neoplasias da Mama/psicologia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/diagnóstico , Pessoa de Meia-Idade , Mastectomia/psicologia , Pesquisa Qualitativa , Adulto , Adaptação Psicológica , Idoso , Apoio Social , Entrevistas como Assunto , Relações Familiares/psicologiaRESUMO
OBJECTIVES: This study aims to quantify the extent to which cognitive emotional regulation and social alienation independently and interactively predict the severity of post-traumatic stress disorder symptoms in patients after radical mastectomy for breast cancer. To test whether cognitive emotional regulation strategies mediate the relationship between fear of cancer recurrence and post-traumatic stress disorder, and to determine whether social alienation mediates the impact of fear of cancer recurrence on post-traumatic stress disorder. It is hypothesized that higher maladaptive cognitive emotional regulation and higher social alienation will respectively explain the unique variations in the severity of post-traumatic stress disorder, rather than merely sociodemographic and medical covariates; The higher the level of cognitive emotional regulation, the more obvious the connection between fear of cancer recurrence and post-traumatic stress disorder. Social distancing can partially mediate the pathway of fear of cancer recurrence - post-traumatic stress disorder. Clarifying these modifiable psychosocial pathways will provide a theoretical basis for alleviating post-traumatic stress disorder in postoperative breast cancer survivors. METHODS: We recruited 256 eligible patients who had undergone breast cancer surgery to participate in the study using a cross-sectional design. The study discussed the interplay among fear of cancer recurrence, social alienation, cognitive emotion regulation, and post-traumatic stress disorder and aimed to develop effective stress intervention strategies for clinical researchers. RESULTS: post-traumatic stress disorder was positively connected with anxiety about cancer recurrence, maladaptive cognitive emotion regulation, and social alienation in patients after breast cancer surgery. Furthermore, the connection between fear of cancer recurrence and post-traumatic stress disorder was influenced by individual maladaptive cognitive emotion regulation and social alienation. CONCLUSION: The fear of cancer recurrence can lead to an increase in post-traumatic stress disorder among breast cancer patients after surgery. This increase is influenced by the adaptability of cognitive emotion regulation and social alienation. Hence, Efforts should be made to prevent negative cognitive emotion regulation. Additionally, patients should be encouraged and supported to enhance their confidence in social interactions and reduce social alienation. These measures aim to alleviate the symptoms of post-traumatic stress disorder. CLINICAL TRIAL NUMBER: Not applicable.
Assuntos
Neoplasias da Mama , Regulação Emocional , Recidiva Local de Neoplasia , Alienação Social , Transtornos de Estresse Pós-Traumáticos , Humanos , Feminino , Transtornos de Estresse Pós-Traumáticos/psicologia , Neoplasias da Mama/psicologia , Neoplasias da Mama/cirurgia , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/psicologia , Adulto , Estudos Transversais , Alienação Social/psicologia , Mastectomia/psicologia , Medo/psicologia , IdosoRESUMO
Background and Objectives: There is a worldwide increase in the demand for gender-affirming surgical treatments among transgender and gender-diverse (TGD) adults and adolescents. In Poland, transgender people generally lack trust in healthcare providers, which makes it more difficult for them to begin their transition process. This patient population is not well understood by many of the specialists who may potentially be involved in their care, in some way, reinforcing their concerns. The aim of this study is to present the sociodemographic characteristics of a group of female-to-male transgender patients who were admitted to a privately based plastic surgery center to undergo chest wall reconstruction. Materials and Methods: This study comprises a statistical analysis of data retrospectively obtained from the medical records of 100 patients from across the country undergoing female-to-male transition, who were operated on between 2021 and 2025 at a specialized private clinic in Poland. All individuals had already started gender-affirming medical treatment with testosterone at the time of first consultation. Results: The results show a trend toward a decreasing age at the time of the decision to undergo gender-affirming surgery. In the study group, 100% of patients were already undergoing hormone therapy. In our group of transgender individuals, we did not observe a correlation between cultural or social background, religion, and gender dysphoria. It is encouraging that more than half of the patients reported no longer needing psychiatric support, and that those who were still under specialist supervision stated that they experienced a significant improvement in their overall well-being. Conclusions: The rising demand for transgender healthcare highlights the need for studying and analyzing this group of patients in order to provide the best patient-centered care throughout the gender transition process by all specialists involved. Gender-affirming mastectomy, when combined with testosterone therapy, has a positive mental health impact on transgender individuals.
Assuntos
Cirurgia de Afirmação de Gênero , Mastectomia , Pessoas Transgênero , Humanos , Polônia , Estudos Retrospectivos , Feminino , Adulto , Masculino , Pessoas Transgênero/psicologia , Pessoas Transgênero/estatística & dados numéricos , Cirurgia de Afirmação de Gênero/métodos , Cirurgia de Afirmação de Gênero/estatística & dados numéricos , Cirurgia de Afirmação de Gênero/psicologia , Pessoa de Meia-Idade , Mastectomia/métodos , Mastectomia/estatística & dados numéricos , Mastectomia/psicologia , Estudos de Coortes , AdolescenteRESUMO
Background: Mastectomy can lead to profound psychological effects, including a disturbed body image, particularly among geriatric women. Body image concerns post-surgery often contribute to emotional distress, social withdrawal, and decreased quality of life. This study aimed to evaluate the effectiveness of basic counseling in enhancing body image among geriatric women after mastectomy. Objectives: To assess changes in body image scores before and after a structured counseling intervention, and to evaluate the association between demographic variables and body image perception among geriatric women post-mastectomy. Methods: A quasi-experimental study with a pretest-posttest control group design was conducted among 140 geriatric women (≥65 years) who had undergone mastectomy in selected hospitals of Madurai and Tirunelveli districts. Participants were equally divided into experimental (n=70) and control (n=70) groups using purposive sampling. The experimental group received structured basic counseling in four sessions over 60 days, while the control group received routine postoperative care. Body image was assessed using a 22-item Likert-scale tool at four time points: pretest (day 3 post-surgery), posttest-I (day 10), posttest-II (day 30), and posttest-III (day 60). Data were analyzed using repeated measures ANOVA, chi-square tests, and descriptive statistics. Results: The experimental group showed a significant improvement in mean body image scores from 50.89 (pretest) to 77.23 (posttest-III), compared to minimal change in the control group (51.17 to 52.46). Repeated measures ANOVA revealed statistically significant differences (F = 21.97, p < 0.001). No significant associations were found between body image scores and demographic variables. The body image gain score was 25.86% in the experimental group versus 2.57% in the control group. Conclusion: Basic counseling significantly enhanced positive body image among geriatric women after mastectomy. Incorporating structured psychosocial interventions into post-mastectomy care is recommended.
Assuntos
Imagem Corporal , Aconselhamento , Mastectomia , Humanos , Feminino , Mastectomia/psicologia , Imagem Corporal/psicologia , Idoso , Aconselhamento/métodos , Idoso de 80 Anos ou mais , Neoplasias da Mama/cirurgiaRESUMO
OBJECTIVE: To evaluate the effectiveness of an integrative intervention combining psychological and physical therapies with pharmacologic treatment for postmastectomy pain syndrome (PMPS), and to assess its impact on pain, anxiety, and quality of life in breast cancer patients. METHODS: In this prospective randomized controlled study, 302 breast cancer patients with chronic postoperative pain were assigned to a control group (standard pharmacologic treatment) or an experimental group (combined drug, psychological, and physical therapies). Key outcomes included NRS scores during movement and rest, pain interference, Hospital Anxiety and Depression Scale (HADS), and Breast-Q scores, assessed at T0 (baseline), T1 (end of intervention), and T2 (3 months after intervention). RESULTS: At T2, the experimental group showed significantly lower movement NRS scores (p = 0.0143), pain interference scores (p = 0.0488), and anxiety scores (p = 0.0001) compared to the control group. Two-way ANOVA revealed significant time × group interactions for multiple pain-related outcomes (p < 0.05). Quality of life improved over time (p = 0.0026), but no significant between-group difference was found. CONCLUSION: A multimodal integrative intervention combining psychological and physical therapies can enhance pain relief and emotional well-being in patients with PMPS. This approach supports the application of integrative medicine in oncology rehabilitation.
Assuntos
Neoplasias da Mama , Mastectomia , Manejo da Dor , Dor Pós-Operatória , Modalidades de Fisioterapia , Humanos , Feminino , Pessoa de Meia-Idade , Mastectomia/efeitos adversos , Mastectomia/psicologia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , Qualidade de Vida/psicologia , Dor Pós-Operatória/terapia , Dor Pós-Operatória/psicologia , Dor Pós-Operatória/tratamento farmacológico , Estudos Prospectivos , Ansiedade/terapia , Ansiedade/psicologia , Terapia Combinada , Adulto , Idoso , Resultado do Tratamento , Manejo da Dor/métodos , Assistência Centrada no Paciente , Medição da Dor , Depressão/psicologia , Depressão/terapiaRESUMO
PURPOSE: Preoperative anxiety is a significant concern, particularly among women undergoing procedures that may alter body image, such as a mastectomy. If untreated, this anxiety can lead to complications, underscoring its importance in preoperative care. Identifying nursing interventions with minimal side effects is crucial, given the potential of modern treatments to exacerbate anxiety. Therefore, this study aims to determine and compare the effect of aromatherapy and music therapy on physiological indices and preoperative anxiety of female mastectomy candidates. METHODS: A three-group randomized clinical trial was conducted on 99 female mastectomy candidates at the Cancer Institute of Imam Hospital, Tehran. Participants were selected using convenience sampling and randomly assigned to aromatherapy, music therapy, or control groups. The intervention included 30 min of receptive music therapy using selected pieces or inhalation aromatherapy with Damask rose, while the control group received usual nursing care. Anxiety levels were measured using the NVAAS scale and physiological indicators, including vital signs and salivary cortisol, before and 10 min after the intervention. Data analysis was performed using SPSS version 16. RESULTS: The findings of this research show that all groups experienced an improvement in anxiety scores, but the impact of the two intervention groups was more significant and effective (p < 0.001). Alterations in physiological indices showed no statistically significant difference in the control group (p > 0.05). Physiological indices variations, except SpO2 (p > 0.05), indicate that both intervention groups were significant (p ≤ 0.05). Aromatherapy has also been effective in improving patients' heart rate (p = 0.004). CONCLUSION: This study demonstrated that the use of two complementary medicine approaches, inhalation aromatherapy and receptive music therapy, can be effective in reducing preoperative anxiety in patients and improving physiological indices. Employing such noninvasive approaches with minimal side effects and favorable for patients in clinical settings is recommended. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: IRCT20230221057482N1.
Assuntos
Ansiedade , Aromaterapia , Neoplasias da Mama , Mastectomia , Musicoterapia , Cuidados Pré-Operatórios , Humanos , Feminino , Aromaterapia/métodos , Ansiedade/terapia , Ansiedade/etiologia , Musicoterapia/métodos , Pessoa de Meia-Idade , Mastectomia/psicologia , Adulto , Cuidados Pré-Operatórios/métodos , Irã (Geográfico) , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , IdosoRESUMO
PURPOSE: To evaluate the impact of psychoeducation on body image and sexual quality of life in women after mastectomy due to breast cancer. METHODS: This randomized controlled trial was conducted from October 2023 to January 2025 in a university hospital's general surgery clinic. A total of 63 mastectomy patients participated: 31 in the psychoeducation group and 32 in the control group. Data were collected using the the Breast Cancer Body Image Scale (BCBIS) and the Sexual Quality of Life-Female (SQoL-F) questionnaire. After the pretest was administered to all patients, those in the psychoeducation group received psychoeducation sessions for 6 weeks, 90 min weekly. Following the six-week training, a 4-week waiting period was observed. The pretests were administered to all patients before the initiation of psychoeducation, and the posttests to all patients 4 weeks after completion of psychoeducation. RESULTS: There were no significant differences between groups in the pretest BCBIS and SQoL-F scores (p > 0.05). However, posttest scores significantly improved in the psychoeducation group compared to the control group across all measures (p < 0.05). Within-group comparisons showed the psychoeducation group experienced significant improvement in posttest scores compared to pretest (p < 0.05). While the control group showed significant change in SQoL-F scores (p < 0.05), no significant change was found in BCBIS scores (p > 0.05). CONCLUSION: This study highlights the unmet needs of women following breast cancer treatment and underscores the importance of psychosocial support services, including socialization and counseling. It indicates that psychoeducation improves body image and sexual quality of life in mastectomy patients.
Assuntos
Imagem Corporal , Neoplasias da Mama , Mastectomia , Educação de Pacientes como Assunto , Qualidade de Vida , Comportamento Sexual , Humanos , Feminino , Qualidade de Vida/psicologia , Imagem Corporal/psicologia , Mastectomia/psicologia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , Pessoa de Meia-Idade , Educação de Pacientes como Assunto/métodos , Adulto , Inquéritos e Questionários , Comportamento Sexual/psicologia , IdosoRESUMO
BACKGROUND: Breast cancer remains the most frequently diagnosed cancer among women globally, including Malaysia. Patient reported outcomes (PROs) such as satisfaction and quality of life (QOL) have become crucial in evaluating the effectiveness of breast surgery, especially as survival rates improve. The BREAST-Q, a validated PRO measure, was developed to assess these factors from the patient perspective. This study aims to evaluate and compare the QOL and satisfaction outcomes between mastectomy and breast-conserving surgery (BCS) among Malaysian breast cancer patients. METHODS: This multi-center, prospective cohort study included 230 women with stage 0 to III breast cancer undergoing mastectomy or BCS from January 2022 to April 2023. This study was conducted at Universiti Malaya Medical Center, Hospital Putrajaya, and Hospital Sultan Ismail Johor Bahru. The BREAST-Q questionnaire was administered preoperatively, and at 6 and 12 months postoperatively. Data were analyzed using descriptive statistics, independent t-tests, and ANOVA for multivariate analysis. RESULTS: Out of 230 patients, 49.6% had mastectomies, and 50.4% had BCS. BCS patients reported significantly higher satisfaction and QOL across domains, particularly in psychosocial and sexual well-being at all postoperative time points. Physical well-being favored the BCS group only at the 12-month mark. Satisfaction with the surgeon and medical team was notably higher in the mastectomy group. CONCLUSIONS: BCS was associated with higher patient satisfaction and QOL than mastectomy, suggesting it as a beneficial surgical option. The BREAST-Q tool provides a valuable framework to aid patient-surgeon discussions, improve patient preparedness, and inform surgical decision-making.
Assuntos
Neoplasias da Mama , Mastectomia Segmentar , Mastectomia , Medidas de Resultados Relatados pelo Paciente , Satisfação do Paciente , Qualidade de Vida , Humanos , Feminino , Estudos Prospectivos , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , Neoplasias da Mama/patologia , Pessoa de Meia-Idade , Mastectomia/psicologia , Malásia , Satisfação do Paciente/estatística & dados numéricos , Adulto , Mastectomia Segmentar/psicologia , Idoso , Inquéritos e QuestionáriosRESUMO
Background: Despite evidence discouraging contralateral prophylactic mastectomy (CPM) in average-risk patients, its use is increasing globally. While well-studied in Western settings, little is known about the factors influencing CPM decisions in the Middle East and North Africa (MENA) region. This study explores clinical, psychosocial, and communication-related factors associated with CPM choices among women with early-stage breast cancer. Methods: We conducted a retrospective study of 253 early-stage breast cancer patients who underwent mastectomy, with or without CPM, at the American University of Beirut Medical Center. Clinical and demographic data were extracted from medical records, and decision-making factors were assessed through tailored patient questionnaires. Associations were analyzed using chi-square tests and multivariable logistic regression. Results: Of the 253 women included in the study, 37 underwent CPM, while 216 had unilateral mastectomy (UM). Compared to the UM group, women who chose CPM were more likely to have a college education (96.9% vs. 57.6%, p < 0.001), be employed (69.7% vs. 41.3%, p = 0.002), and report a family history of breast cancer (55.6% vs. 30.2%, p = 0.003). Immediate reconstruction was significantly more common among CPM patients (67.6% vs. 16.4%, p < 0.001), and the 30-day rehospitalization rate was also higher (16.2% vs. 6.1%, p = 0.031). Women in the CPM group were more likely to prioritize extending life (84.6% vs. 56.7%, p = 0.007) and achieving peace of mind (80.8% vs. 49.3%, p = 0.003). Although all CPM patients cited risk reduction as a primary motivator, only 46.2% believed they had a lower recurrence risk than their peers (vs. 20% of UM patients, p < 0.001). Decisions to undergo UM were more frequently influenced by physicians' recommendations (95.3% vs. 53.8%, p < 0.001), whereas CPM decisions appeared to be more patient-driven. Additionally, CPM patients reported more negative expectations and higher dissatisfaction with pain (57.7% vs. 32.0%, p = 0.012) and reconstructive outcomes (54.5% vs. 27.5%, p = 0.035). Conclusions: In this first study from the MENA region exploring CPM decision-making, choices were largely driven by personal preferences rather than clinical risk. These findings highlight the need for improved risk communication, shared decision-making, and broader integration of genetic counseling in surgical planning.
Assuntos
Neoplasias da Mama , Comunicação , Tomada de Decisões , Mastectomia , Mastectomia Profilática , Humanos , Feminino , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , Pessoa de Meia-Idade , Adulto , Estudos Retrospectivos , Mastectomia/psicologia , Mastectomia Profilática/psicologia , Idoso , Inquéritos e QuestionáriosRESUMO
PURPOSE: This study aims to examine the representations of breast neoplasms among sexual minority women (SMW) with breast cancer and those without a history of the disease. METHOD: This qualitative study included 10 lesbian women and one bisexual woman. Semi-structured interviews were conducted, transcribed, and analyzed using the reflexive thematic analysis approach. RESULTS: Two main themes emerged from the analysis: (1) implications of cancer treatment, encompassing the subthemes: consequences of mastectomy, body hair loss, effects of adjunct therapy, and emotional responses to treatment; (2) contact with healthcare services, including discussions about sexual orientation and perceived discrimination. CONCLUSION: The experiences of women who had undergone cancer treatment were accurately reflected in the narratives of participants without a history of the disease. The types of treatments, the physical and emotional consequences of cancer, and the potential for discrimination or discomfort were recurring topics in the participants' accounts. This study hopes to contribute to a deeper understanding of the individual and collective meanings attributed to breast cancer among Brazilian women, particularly within the context of sexual minority communities.
Assuntos
Bissexualidade , Neoplasias da Mama , Homossexualidade Feminina , Minorias Sexuais e de Gênero , Humanos , Feminino , Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , Brasil , Pessoa de Meia-Idade , Adulto , Pesquisa Qualitativa , Minorias Sexuais e de Gênero/psicologia , Homossexualidade Feminina/psicologia , Mastectomia/psicologia , Entrevistas como Assunto , Bissexualidade/psicologia , IdosoRESUMO
BACKGROUND: Breast cancer survivorship is increasingly prevalent, yet quality of life (QoL) outcomes post-mastectomy remain a critical concern in Africa. Women post-mastectomy encounter significant physical, psychological, social, and sexual health challenges that are inadequately addressed in clinical settings. Using standardised tools to measure QoL post-mastectomy of women is imperative. Thus, this scoping review aims to map evidence on the use of standardised tools to measure post-mastectomy quality of life among women in Africa. METHODS: This scoping review followed the Levac et al. framework. A systematic search-between 2015 and 2025 across Africa-yielded 473 records: 345 from five databases-CINAHL (n = 22), Emcare (n = 55), Medline (n = 65), Scopus (n = 78), and Web of Science (n = 125)-and 128 from other sources. Ultimately, 34 studies met the inclusion criteria for data extraction and thematic analysis. The review followed PRISMA-ScR guidelines. RESULTS: The 34 studies reviewed involved 5466 participants. Mean ages ranged from 38 to 57 years. QoL post-mastectomy was evaluated using standardised tools such as the EORTC QLQ-C30/BR23, WHOQOL-BREF, BREAST-Q, and FACT-B. Several studies translated and validated QoL assessment tools into local languages, notably Arabic and Yoruba, enhancing contextual relevance. Mastectomy negatively affected overall QoL, body image, psychological wellbeing, sexual functioning, and social relationships. Educational and psychosocial interventions enhanced QoL, particularly those integrating self-compassion training, physical rehabilitation, and group counselling. CONCLUSION: QoL post-mastectomy among women in Africa is significantly compromised; however, targeted psychosocial and rehabilitation interventions show promise in improving survivorship outcomes. Future research should emphasise culturally sensitive, multidisciplinary programs and adopt longitudinal designs to assess sustained effects on QoL. IMPLICATIONS FOR CANCER SURVIVORS: This scoping review emphasises the need for comprehensive post-mastectomy care that includes physical, psychological, sexual, social and financial aspects. Culturally sensitive and accessible interventions are essential for improving the quality of life and long-term outcomes for women in Africa.
Assuntos
Neoplasias da Mama , Mastectomia , Qualidade de Vida , Humanos , Qualidade de Vida/psicologia , Feminino , Mastectomia/psicologia , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , África , Adulto , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
Phantom breast syndrome, a postmastectomy phenomenon characterized by phantom sensations and body image distortion, affects breast cancer survivors' quality of life. Oncology nurses support early identification, patient edu.
Assuntos
Imagem Corporal , Neoplasias da Mama , Mastectomia , Enfermagem Oncológica , Humanos , Feminino , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , Neoplasias da Mama/enfermagem , Qualidade de Vida , Mastectomia/efeitos adversos , Mastectomia/psicologia , Imagem Corporal/psicologia , Pessoa de Meia-Idade , Adulto , SíndromeRESUMO
BACKGROUND: This study aimed to investigate changes in depression, anxiety, fear of cancer recurrence (FCR), pain, and quality of life (QOL) over 48 months after discharge from primary treatment among breast cancer patients, and to examine the effects of different cancer treatment modalities (i.e., surgery, chemotherapy, and radiotherapy) on long-term physical and psychological outcomes and QOL. METHODS: This is a longitudinal prospective study. All participants completed a battery of questionnaires (PHQ-9, GAD-7, FCR-7, MPQ-VAS, and WHOQOL-BREF) at baseline, 12, 24, and 48 months after discharge. Long-term psychological outcomes and QOL were analyzed using a mixed model repeated measures (MMRM) approach. Group comparisons were expressed as least square (LS) mean differences with corresponding 95% confidence intervals (CIs). RESULTS: A total of 143 women with breast cancer were recruited for the study. The mean age was 42.27 years (SD = 7.75). The mean score of PHQ decreased from 3.50 at baseline (T1) to 1.24 at the 48-month (T4). Anxiety levels dropped from 4.09 at T1 to 2.74 at T4, FCR decreased from 21.72 at T1 to 18.70 at T4, and pain levels decreased from 12.96 at T1 to 11.50 at T4. Participants' QOL increased from 87.77 at baseline to 93.42 at the 12-month (T2), then remained stable thereafter (T3 and T4). The LS mean difference in GAD-7 from baseline to endpoint between participants with or without mastectomy was -2.0996 (95% CI: -3.4842, -0.7150). CONCLUSIONS: Breast cancer patients' depression, anxiety, FCR, and pain levels showed a decreasing trend over 48 months after discharge, while patients' QOL improved at the 12-month follow-up and remained stable throughout the study period. Patients with mastectomy experienced higher levels of anxiety than those with partial lumpectomy after 48 months post-surgery.
Assuntos
Neoplasias da Mama , Qualidade de Vida , Humanos , Feminino , Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , Qualidade de Vida/psicologia , Adulto , Pessoa de Meia-Idade , Estudos Prospectivos , Ansiedade/etiologia , Ansiedade/psicologia , Ansiedade/epidemiologia , Depressão/etiologia , Depressão/psicologia , Depressão/epidemiologia , Estudos Longitudinais , Inquéritos e Questionários , Mastectomia/psicologia , Recidiva Local de Neoplasia/psicologia , Medo/psicologiaRESUMO
BACKGROUND: Postoperative experiences after breast cancer surgery, such as lymphedema, phantom breast sensations, persistent chronic pain, and changes in body image and sexuality, can negatively impact women's quality of life. OBJECTIVE: To investigate women's experiences of sequelae at 3, 6, and 12 months after mastectomy. METHODS: A survey including women ≥18 years, cognitively intact, and Danish speaking was conducted from May 2021 to October 2021. The researchers contacted the participants by telephone using 4 validated questionnaires investigating phantom sensation, body image, quality of life, and sexuality. RESULTS: Forty-four women were eligible for participation, and 23 (14 women aged ≤65 years and 9 women aged >66 years) were included in the analysis. The results showed an overall decrease in the severity of physical sequelae and an improvement in body image and sexual function. However, the women reported concerns about the future and decreased sexual enjoyment. Nearly half of the women received information about sexuality from healthcare professionals. CONCLUSION: The study demonstrated decreased sequelae during the follow-up period. Still, there seem to be unanswered questions concerning the quality of life and the content of information regarding sexuality. The findings require attention and further research to benefit the individual woman and her partner in accommodating the consequences after mastectomy. IMPLICATIONS FOR PRACTICE: Persistent pain and concerns for the future are present for half of the women after 1 year. Information about possible changes in sexuality is not standard. A nurse-patient dialogue that discusses hospitalization and sexuality on an individual level can be a way to address concerns and challenges.
Assuntos
Neoplasias da Mama , Mastectomia , Complicações Pós-Operatórias , Qualidade de Vida , Humanos , Feminino , Mastectomia/efeitos adversos , Mastectomia/psicologia , Seguimentos , Qualidade de Vida/psicologia , Pessoa de Meia-Idade , Idoso , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , Inquéritos e Questionários , Imagem Corporal/psicologia , Adulto , Dinamarca , Complicações Pós-Operatórias/psicologia , Fatores de TempoRESUMO
BACKGROUND: Breast conservation surgery (BCS) has not been a widely adopted treatment in early breast cancer despite its oncological outcomes similar to mastectomy. In emerging economies, BCS rates are < 40% compared to > 70% in the West. Hence, this study was undertaken to describe factors influencing the underutilization of BCS. METHODS: A prospective longitudinal study was conducted between September 2019 and December 2021 on patients with biopsy-proven early breast cancer eligible for BCS. The choice of surgery (mastectomy vs. breast conservation) by patients was recorded at initial diagnosis and staging. A predesigned structured questionnaire was used to identify the factors associated with their choice of mastectomy. The patients received multiple counseling sessions by the operating surgeon(s), and the choice of surgery was recorded again. Factors associated with the choice of surgery were identified and evaluated by univariate or multivariate logistic regression. RESULTS: Out of 238 consecutive patients operated on in the study period, 84 met eligibility criteria and were recruited. At the time of initial diagnosis and staging, 13 (15.5%) patients wanted BCS. After multiple counseling sessions, finally, 75 (89.3%) opted for BCS; however, 9 (10.7%) still wanted mastectomy. The factors influencing the choice of mastectomy were fear of outcome (90% of patients), followed by family influence (35%), radiation-related factors (30%), personal factors (25%), and surgery-related factors (25%). CONCLUSIONS: Systematic counseling by the treating team markedly improved breast conservation acceptance rates from 15.5% to 89.3%. Fear of outcome is the major factor influencing the choice of mastectomy over BCS in early breast cancer patients suitable for BCS.
Assuntos
Neoplasias da Mama , Comportamento de Escolha , Mastectomia Segmentar , Mastectomia , Humanos , Feminino , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , Neoplasias da Mama/patologia , Estudos Prospectivos , Mastectomia Segmentar/psicologia , Mastectomia Segmentar/estatística & dados numéricos , Pessoa de Meia-Idade , Mastectomia/psicologia , Mastectomia/estatística & dados numéricos , Índia , Adulto , Estudos Longitudinais , Idoso , Inquéritos e Questionários , Seguimentos , Pesquisa QualitativaRESUMO
Background: Breast cancer patients often face the choice between breast-conserving surgery and mastectomy. From a shared decision-making perspective, it is crucial for patients to actively engage in the decision-making process, taking into account their own preferences and values. This approach can enhance treatment satisfaction and support the principles of precision nursing. Objective: To evaluate the level and classification of shared decision-making behavior in surgery, along with the influence of participation competence, perceived social support, and self-care self-efficacy, guided by the "Capacity, Opportunity, Motivation-Behavior" model. Method: A multicenter cross-sectional study was conducted in three hospitals in China from January 2021 to March 2022. The survey tools included self-designed demographic and clinical instrument, the Participation in Treatment Decision-Making Scale for cancer patients (PTDMS), the Participation Competence Scale (PCS), the Perceived Social Support Scale (PSSS), and the Strategies Used by People to Promote Health (SUPPH). Latent profile analysis was employed to assess the shared decision-making behavior in surgery. Multivariate logistic regression was applied to identify factors associated with the identified subtypes. Result: A total of 840 participants were ultimately analyzed. The best-fitting model identified three classes: active participation group (55.7%), moderate participation group (21.7%), and low participation group (22.6%). Logistic regression indicated that age, number of children, educational level, family income, employment status, cancer stage, type of surgery, participation competence, perceived social support, and self-care self-efficacy were main associated factors (all p < 0.05). Conclusion: The performance of shared decision-making behaviors in surgery needs improvement. This study may help nurses identify targeted intervention populations who are older, have more than three children, have a higher education level, have a lower family income, are employed, are at an advanced cancer stage, and are opting for mastectomy. It also emphasizes the importance of participation competence, social support, and self-care self-efficacy when designing intervention content.
Assuntos
Neoplasias da Mama , Tomada de Decisão Compartilhada , Humanos , Feminino , Estudos Transversais , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , Pessoa de Meia-Idade , China , Adulto , Inquéritos e Questionários , Idoso , Apoio Social , Autoeficácia , Mastectomia/psicologia , Psicometria/instrumentação , Psicometria/métodosRESUMO
PURPOSE: Around 310,000 new cases of breast cancer (BC) are diagnosed each year. Complex treatment options often overwhelm patients. Patient decision aids (PDAs) assist in surgical decision-making, but reviews of their quality and efficacy are limited. This study systematically reviews breast surgery (BS) and breast reconstruction (BR) PDAs using the International Patient Decision Aid Standards and Cochrane tools to identify gaps and provide evidence-based recommendations. METHODS: A systematic review following PRISMA guidelines examined the impact of PDAs on decision-making for BC patients considering BS and BR. From 1198 articles, 35 met the inclusion criteria. Data on PDA components, study design, and results were extracted, focusing on decisional conflict and anxiety, measured by the Decisional Conflict Scale (DCS) and the State-Trait Anxiety Inventory (STAI). PDA quality and study design were assessed using Cochrane, IPDASi, and ROBINS-I tools. RESULTS: Eight studies evaluated the effect of PDAs on decisional conflict. The pooled mean difference of 3.08 points (95% CI: - 0.62 to 6.79, p = 0.10) favored the PDA group but was not statistically significant. Two studies, however, reported notable reductions in decisional conflict with effect sizes of 13.50 and 12.80 points, respectively. The pooled effect size of PDA exposure on patient anxiety was 1.93 (95% CI: - 0.46 to 4.31) in favor of PDAs, but was not statistically significant (p = 0.11). The evaluation of PDA content quality revealed variable results. CONCLUSION: BS and BR PDAs were not found to significantly reduce decisional conflict and anxiety in breast cancer patients. Standardized, evidence-based tools are needed.
Assuntos
Neoplasias da Mama , Tomada de Decisões , Técnicas de Apoio para a Decisão , Mamoplastia , Mastectomia , Participação do Paciente , Humanos , Neoplasias da Mama/cirurgia , Neoplasias da Mama/psicologia , Feminino , Mamoplastia/psicologia , Mamoplastia/métodos , Mastectomia/psicologia , Conflito PsicológicoRESUMO
BACKGROUND: In this qualitative study, we assessed patients' perception of how postmastectomy breast reconstruction (PMBR) impacts sexual health and the perceived value of consultations with the sexual medicine team. METHODS: PMBR patients were recruited for four focus groups, two with patients who had sexual medicine consultations and two with patients who did not. Patients completed two surveys, BREAST-Q Sexual Well-being and Patient-Reported Outcomes Measurement Information System (PROMIS) Sexual function and satisfaction (SexFS). Focus groups were audio-taped, transcribed, and analyzed thematically. RESULTS: There were 35 participants, 17 patients who received sexual medicine consultations and 18 patients who did not. The median Sexual Well-being score was 48 (Interquartile range: 31, 53) and PROMIS SexFS scores were lower than the United States adults' scores. Analysis identified six major themes: (1) patient experience of physical and nonphysical impacts of diagnosis and treatment that lead to a decline in sexual health, (2) utilization of clinical and nonclinical strategies to address sexual health concerns, (3) patient perception of importance of sexual health and how it is often overlooked in oncology care broadly and in plastic surgery specifically, (4) desired information about sexual health, (5) patient desire for a dedicated place to discuss their sexual health concerns, and (6) desired aspects of sexual medicine consultations. CONCLUSION: Patients perceive a decline in their sexual health as a result of breast cancer diagnosis and treatment, with specific challenges associated with PMBR. Patients desire a dedicated space to discuss sexual health concern, and sexual medicine consultations are one possible approach.