Poster Presentation Cancer Survivorship 2019

Psychosocial and Decisional outcomes Following Breast Reconstruction after Mastectomy: the Role of Body Image Attitudes (#129)

Natasha Hatcher 1 , Danielle Muscat 2 , Sarah Guinta 1 , Lorna Huang 1 , Haryana Dhillon 3 4 , Rebekah Laidsaar-Powell 3 , Susan Carroll 5 6 , Catriona McNeil 5 7 , Lucinda Burke 7 , Pamela Howson 8 , Belinda Chan 7 9 , Ilona Juraskova 3
  1. School of Psychology, Faculty of Science, University of Sydney, Sydney, NSW, Australia
  2. Sydney Health Literacy Lab, School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia
  3. Centre for Medical Psychology & Evidence-based Decision-making, School of Psychology, Faculty of Science, The University of Sydney, Sydney, NSW, Australia
  4. Psycho-Oncology Cooperative Research Group, University of Sydney, NSW, Australia
  5. Faculty of Medicine and Health Sciences, Sydney Medical School, The University of Sydney, NSW, Australia
  6. Northern Cancer Centre, Royal North Shore Hospital, St Leonards, NSW, Australia
  7. Chris O'Brien Lifehouse, Sydney, NSW, Australia
  8. Dept of Breast Surgery, Concord Repatriation General Hospital, Concord, NSW, Australia
  9. Strathfield Private Hospital, Strathfield, NSW

Background: Implant-based and immediate breast reconstructions (BR) are increasingly popular following mastectomy for breast cancer. These BR procedures are associated with additional risks such as implant loss and poorer cosmetic outcomes, compared to alternative procedures. Women’s body image attitudes (investment and evaluation) and decision-making contexts are under-explored in this context.

 

Aims: to investigate whether: i) women’s body image investment predicts body image evaluation and psychological morbidity; ii) body image attitudes differ according to BR type and timing; and iii) BR type and timing predict variance in decisional outcomes, in this population.

Methods: This cross-sectional survey was completed online by women recruited through the Breast Cancer Network of Australia, social media, and participating hospitals. They completed standardised questionnaires assessing: body image attitudes (investment and evaluation), psychological status (depression and anxiety), and decisional outcomes (extent of informed-decision making, decisional satisfaction and regret). Multiple linear regression was performed.

Results: Respondents were 184 Australian women treated with breast cancer, mean age 55 (SD=10.19) years. Higher body image investment predicted higher body image dissatisfaction (p<.001, CI 2.213-4.880), levels of anxiety (p<.001, CI 1.490-3.698), decisional regret (p=0.010, CI 2.791-20.887) and lower decisional satisfaction (p=0.027, CI-0.899—0.056). Body image investment was not associated with a single type of BR.  Decision-making factors did not differ as a result of BR type.

Conclusions. the importance of fostering of realistic expectations prior to BR, as well as enhancements of current decision aids to include aspects of body image schemas.