Isabela Chaves Monteiro Soares, Enilze Maria de Souza Fonseca Ribeiro, Guilherme Batalha, Michelli Esteves de Souza, Flávia Kuroda Yamanishi, Iris Rabinovic
Risk-reducing mastectomy with immediate reconstruction is associated with variable psychosocial and sexual outcomes, primarily influenced by postoperative complications and reoperations. These findings highlight the importance of incorporating quality-of-life assessment into the counseling and follow-up of these patients.
INTRODUCTION: Risk-reducing mastectomy significantly decreases the incidence of breast cancer in women with a genetic predisposition. However, its effects on psychosocial and sexual well-being remain insufficiently explored, particularly among women without a previous diagnosis of breast cancer.
OBJECTIVE: To evaluate the psychosocial and sexual well-being of women undergoing risk-reducing mastectomy with immediate breast reconstruction.
METHODS: This observational, cross-sectional study involved the retrospective collection of clinical data and was conducted at a specialized center. Women aged >18 years, with no history of breast cancer, who underwent bilateral risk-reducing mastectomy with immediate implant-based reconstruction between 2018 and 2023 were included. Psychosocial and sexual well-being domains were assessed using the BREAST-Q™, with standardized scores ranging from 0 to 100. Descriptive analyses, Spearman's correlation, and nonparametric tests were performed, adopting a significance level of P < 0.05.
RESULTS: Twenty-eight patients were included. The mean age was 41.8 ± 9.6 years at the time of surgery and 45.5 ± 9.4 years at the time of assessment. Mean scores were 68.5 ± 20.4 for psychosocial well-being and 55.4 ± 17.8 for sexual well-being. A strong correlation was observed between the two domains (ρ = 0.81; p < 0.001). Early postoperative complications and the need for reoperations were associated with lower scores in both domains. Higher educational attainment was associated with better sexual well-being scores. No significant associations were found for the remaining variables.
CONCLUSION: Risk-reducing mastectomy with immediate reconstruction is associated with variable psychosocial and sexual outcomes, primarily influenced by postoperative complications and reoperations. These findings highlight the importance of incorporating quality-of-life assessment into the counseling and follow-up of these patients.