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Effects of Expectations and Body Image in Breast Reconstruction

Recruiting
Conditions
Breast Cancer
Interventions
Procedure: Implant-based breast reconstruction
Procedure: Autologous breast reconstruction
Procedure: Combined methods
Registration Number
NCT04714463
Lead Sponsor
Vastra Gotaland Region
Brief Summary

A breast reconstruction after mastectomy, either due to breast cancer or a high lifetime risk for cancer, is performed to increase the patient's quality of life. However, there are studies that show that some women regret their decision to have breast reconstruction. There are also studies demonstrating similarities in the general patterns of psychosocial adjustment and quality of life among women with breast cancer who have undergone breast-conserving surgery, mastectomy alone, and mastectomy combined with breast reconstruction. Hence, it is unclear which women actually benefit from a breast reconstruction. The concept of quality of life is connected to patient satisfaction and body image/investment. Therefore, the aim of this project is to examine the effects of patient expectations and body image on the patient reported outcomes of breast reconstruction, to improve preoperative information and postoperative care for women considering a breast reconstruction.

Detailed Description

Not available

Recruitment & Eligibility

Status
RECRUITING
Sex
Female
Target Recruitment
500
Inclusion Criteria
  • Biological women with breast cancer or high risk for breast cancer who want post-mastectomy breast reconstruction
  • Age > 18 years
Exclusion Criteria
  • Inability to give informed consent
  • Inability to understand Swedish
  • Relaps of cancer
  • Palliative treatment

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Arm && Interventions
GroupInterventionDescription
Immediate breast reconstructionCombined methodsWomen undergoing immediate breast reconstruction due to breast cancer or a high risk for breast cancer
Delayed breast reconstructionCombined methodsWomen undergoing delayed breast reconstruction due to breast cancer or a high risk for breast cancer
Delayed breast reconstructionAutologous breast reconstructionWomen undergoing delayed breast reconstruction due to breast cancer or a high risk for breast cancer
Immediate breast reconstructionImplant-based breast reconstructionWomen undergoing immediate breast reconstruction due to breast cancer or a high risk for breast cancer
Immediate breast reconstructionAutologous breast reconstructionWomen undergoing immediate breast reconstruction due to breast cancer or a high risk for breast cancer
Delayed breast reconstructionImplant-based breast reconstructionWomen undergoing delayed breast reconstruction due to breast cancer or a high risk for breast cancer
Primary Outcome Measures
NameTimeMethod
Patient satisfaction with breast reconstruction measured with Breast Q reconstruction2 years

Breast Q reconstruction includes two domains and six different modules: health-related quality of life (HR-QOL; including physical, psychosocial, and sexual well-being) and patient satisfaction (including satisfaction with breasts, outcome, and care). Each scale produces an independent score from 0-100. A higher score means greater satisfaction or better QOL.

Patient expectations measured with Breast Q expectations2 years

Breast Q expectations.The scale consists of five modules: expectations for support from medical staff , expectations for pain, expectations for coping, expectations for breast appearance when clothed and expectations for breast sensation. The score for each independent scale range from 0-100. A higher score means greater expectations.

Body image measured with Multidimensional body-self relations questionnaire- appearance scales (MBSRQ-AS)2 years

MBSRQ-AS - Multidimensional body-self relations questionnaire- appearance scales.It is a 34-item self-report questionnaire designed to measure appearance related components of body-image. In consists of five subscales: appearance evaluation, appearance orientation, body areas satisfaction, overweight preoccupation, and self-classified weight. It is a 5-point Likert-scale ranging from 1 to 5.

Body image investment measured with Appearance schemas inventory-revised (ASI-R)2 years

ASI-R - Appearance schemas inventory-revised: is a 20-item self-report questionnaire designed to measure body-image investment. It consists of two subscales, self-evaluative salience (SES) and motivational salience (MS). It is a 5-point Likert-scale ranging from 1 (strongly disagree) to 5 (strongly agree). Twelve items relate to SES and eight items relate to MS. The total score is the mean of the 20 items, and the score of the subscales is the mean of the items relating to each subscale. A high score indicates greater body-image investment.

Secondary Outcome Measures
NameTimeMethod
Demographic factors and medical factors according to medical charts2 years

Demographic factors that might affect expectations and satisfaction, such as age, comorbidity, and previous cosmetic breast surgery, and medical factors such as timing of reconstructions, reason for mastectomy, type of cancer and cancer treatment received.

Satisfaction with preoperative information measured with Breast Q reconstruction2 years

Measured with one of the sub scales of Breast Q reconstruction

Depression and anxiety measured with Hospital Anxiety and Depression Scale (HADS)2 years

HADS - Hospital Anxiety and Depression Scale: is a 14-item self-report questionnaire that is designed to measure anxiety and depression. It has two domains, where seven items relate to anxiety and seven relate to depression. It is a 4-point Likert-scale ranging from 0-3. Each domain has a maximum score of 21. For both domains, scores of less than 7 indicate non-cases, whereas scores of 8-10 indicate mild anxiety or depression, 11-14 moderate and 15-21 severe.

Pain measured with a visual analogue scale2 weeks

Measured with a post-operative pain dairy with VAS scales (o means no pain and 10 means the worst possible pain imaginable)

Sick leave according to authorities1 year

Actual sick leave according to the Swedish authorities

Number of out-patient visits according to the medical charts1 year

Actual number of out-patient visits, according to the medical chart

Trial Locations

Locations (1)

Sahlgrenska university hospital

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Gothenburg, Sweden

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