Breast reconstruction can have lasting benefits

Breast reconstruction after cancer surgery can have lasting benefits for women's psychological well-being and body image, a new study suggests.

Research has shown that for women who have a mastectomy to treat breast cancer, reconstructive surgery can provide a psychological lift, helping to improve self-esteem and body image.

But whether those benefits last - and whether they differ based on the type of breast reconstruction - has been less clear.

In the current study, of 173 breast reconstruction patients, researchers found that many of the psychological gains women had shortly after the surgery were still apparent two years later.

On average, the women were still reporting improvements in energy, anxiety and ability to work and enjoy social activities.

And the type of reconstruction had "surprisingly limited effect," according to the researchers, led by Dr. Dunya Atisha of the University of Michigan Medical Center in Ann Arbor.

They report the findings in the June issue of the Annals of Surgery.

The study included 173 women who had undergone breast reconstruction at one of 12 U.S. medical centers. The majority had immediate reconstruction, done at the time of their mastectomy, but some waited to have the procedure.

The patients also varied in the type of reconstruction they had. The majority underwent a procedure known as TRAM, where tissue from the lower abdomen is used to reconstruct the breast, while about one-quarter were given artificial implants.

In general, Atisha's team found, the long-term psychological benefits were similar regardless of the type of surgery the women had. There were some differences, however, between women who'd had immediate reconstruction and those who'd delayed the procedure.

Women in the latter group tended to have fewer gains in psychological well-being - the one exception being body-image improvements.

The reasons for the differences between the two groups are not clear. But the decision to delay breast reconstruction is not always based on a woman's preferences; some women, for example, may need to delay the procedure because they are having radiation therapy after their mastectomy.

According to Atisha's team, studies should continue to follow breast reconstruction patients over the long term to see how different procedures ultimately affect their psychological well-being.

SOURCE: Annals of Surgery, June 2008.