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The impact of scars on health-related quality of life after breast surgery: a qualitative exploration

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Purpose The purpose of this research was to explore women’s experiences after breast surgery with scar characteristics and
symptoms, and its impact on their health-related quality of life (HRQOL).
Material andmethods A qualitative study using semi-structured face-to-face interviewswas conducted among women following
prophylactic, oncologic, or reconstructive breast surgery in the Netherlands. A directed content analysis was performed using
guiding themes. Themes were “physical and sensory symptoms,” “impact of scar symptoms,” “personal factors,” “impact of scar
interventions,” and “change over time.”
Results The study population consisted of 26 women after breast surgery. Women experienced a wide range of symptoms like
adherence, stiffness, pain, and uncomfortable sensations. Scar characteristics as visibility, location, texture, and size, influenced
satisfaction with their appearance. The impact of scar symptoms is reflected in physical, social, emotional, and cognitive
functioning, thereby affecting HRQOL. The experienced impact on HRQOL depended on several factors, like personal factors
as the degree of acceptance and environmental factors like social support.
Conclusion Women can experience a diversity of scar characteristics and symptoms, which play a central role in the perceived
impact on HRQOL. Since scarring can have a considerable impact on HRQOL, scarring after prophylactic, oncologic and
reconstructive breast surgery should be given more attention in clinical practice and research.
Implications for Cancer Survivors Considering scarring as a common late effect after breast surgery and understanding the variety
of experiences, which could impact HRQOL of women, can be beneficial in sufficient information provision, expectation
management, and informed decision making.


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