Comparison of Patient Satisfaction and Body Image after “Breast Conserving Surgery” and “Immediate Breast Reconstruction with Prosthesis after Mastectomy”

Different clinical trials showed that survival of Breast Conserving Surgery (BCS) and mastectomy is the same. However change in the appearance of a woman cause psychological trauma and could affect her quality of life. The aim of this study was to compare BCS and post-mastectomy reconstruction by prosthesis in terms of satisfaction and body image (BI) in Breast Cancer Research Center and Imam Khomeini Hospital. Breast cancer patients in stage 0, I, II who completed their treatment at least 3 months ago were included since august 2016 till October 2017. The Persian version of the BICI (Body Image Concern Inventory) questionnaire was used and Patients’ satisfaction was evaluated by scoring and also four-scale answers. The mean score of outcomes were measured by SPSS software and correlation between demographic variables like age and marital status and outcomes were analyzed by non-parametric Kruskal-Wallis& Mann-Whitney. A total of 70 patients with BCS cases and 43 patients with prosthetic reconstruction were enrolled. The mean follow up time was 43.5 months (3-288) and the mean age was 44.3. There were no significant difference between two groups in terms of age, occupation, educational level and marital status except for economic status which was higher in econstruction group. The mean score for BI for BCS was 33.4 and for reconstruction group was 33.8. There was no significant difference between two groups in term of body image, also between demographic variables and body image. The mean score for patient satisfaction was 9.49 in BCS group and 8.89 in reconstruction group (P=0.004). Two groups were significantly different in term of satisfaction, it means that BCS patients were more satisfied about their surgery. Older patients were more satisfied in comparison to younger ones. Breast Conserving Surgery and Mastectomy with reconstruction by prosthesis were not significantly different in term of Body Image, but the satisfaction of surgery was worse in reconstruction group. The preferred option for breast cancer surgery is breast conservation if there are no contraindications. However reconstruction should be offered to patients for better body image and satisfaction