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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Breast cancer is the most prevalent form of cancer that affects women worldwide, posing a significant burden on public health. While advancements in early detection and improved treatments have led to a remarkable 90% five-year survival rate and an 83% ten-year survival rate, this has also resulted in more prophylactic mastectomies being performed. Despite advancements in breast-conserving techniques, immunotherapy, and hormone therapy, many women still undergo mastectomies as part of their cancer treatment. In all cases, this results in scarring, and additional side effects from treatment modalities may arise. The loss of a breast can profoundly impact health-related quality of life (HRQoL). Although HRQoL has improved greatly during the recent years, systematic and local therapy having side effects is not uncommon, and this needs more attention.
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Purpose: This research aimed to explore factors associated with patient-reported breast and abdominal scar quality after deep inferior epigastric perforator (DIEP) flap breast reconstruction (BR). Material and Methods: This study was designed as a descriptive cross-sectional survey in which women after DIEP flap BR were invited to complete an online survey on breast and abdominal scarring. The online survey was distributed in the Netherlands in several ways in order to reach a diverse population of women. Outcomes were assessed with the Patient Scale of the Patient and Observer Scar Assessment Scale (POSAS). Additional items were assessed with a numeric rating scale (NRS). Results: A total of 248 women completed the survey. There was a statistically significant worse POSAS scar appraisal for the abdominal scar compared with the breast scar. The vast majority of women reported high scores on at least one scar characteristic of their breast scar or ab- dominal scar. Overall, color, stiffness, thickness, and irregularity scored higher than pain and itching. Women were only moderately positive about the size, noticeability, location, and the information provided regarding scarring. Conclusion: It is crucial to address the inevitability of scars in patient education before a DIEP flap BR, with a particular focus on the abdominal scar, as women experience abdominal scars significantly worse than their breast scars. Providing more information on the experience of other women and the expected appearance will contribute to having realistic expectations while allowing them to make well-informed decisions.
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In Nederland krijgt één op de zeven vrouwen borstkanker. Paramedici, waaronder huidtherapeuten, krijgen te maken met vrouwen die last hebben van hun littekens na een borstoperatie. Welke klachten hebben deze vrouwen en hoe kunnen we ze verminderen of voorkomen?Doel We willen de effectiviteit onderzoeken van niet-chirurgische behandelingen bij het voorkomen en herstellen van littekens na borstoperaties. Het gaat hierbij om borstoperaties ten gevolge van borstkanker. Het doel hiervan is de kwaliteit van het litteken verbeteren en daarmee de levenskwaliteit van de vrouwen. Resultaten Dit onderzoek loopt nog. Na afronding vind je hier een samenvatting van de resultaten. Looptijd 01 december 2017 - 01 december 2021 Aanpak We hebben inmiddels 26 vrouwen geïnterviewd die een borstoperatie hebben gehad ten gevolge van borstkanker. We vroegen ze naar hun ervaringen met littekens na de borstoperatie. We onderzoeken hoeveel invloed de littekens hebben op hun kwaliteit van leven. In een tweede studie gebruiken we vragenlijsten om deze inzichten verder te onderzoeken. Tegelijkertijd voeren we een literatuuronderzoek uit naar mogelijke niet- chirurgische behandelingen om littekens te voorkomen of herstellen. Vervolgens ontwikkelen we een behandelprogramma en testen dit in de beroepspraktijk.
