title: Prospective analysis of psychosocial outcomes after breast reconstruction: cross-cultural comparisons of 1-year postoperative results.
abstract: Breast reconstruction has been shown to improve quality of life in women following mastectomy for breast cancer. To date, there have been no published prospective reports looking at the effect nationality has on patient quality of life following breast reconstruction. Women from the USA, Sweden and Canada were recruited prior to reconstruction and followed prospectively for 1 year postoperatively. Thirteen centres with 24 plastic surgeons were involved. Preoperatively and 1 year postoperatively, women completed the Short Form-36 questionnaire. Data were analysed using t-tests and analysis of variance. A total of 313 women were followed up. American women who had immediate expander/implant surgery were compared with Swedish patients, whilst Americans who had undergone transverse rectus abdominis myocutaneous (TRAM) flap reconstructions were compared with Canadians. Women benefited from having breast reconstruction, but this improvement was not dependent upon country of origin. Swedish women reported less improvement in one subscale, that of general health, compared with American women (P=0.01). There were no cultural differences detected between Americans and Canadians.
authors.affiliation: University of Michigan Health System, Division of Plastic Surgery, 2130 Taubman Center, 1500 East Medical Center Drive, Ann Arbor, MI 48109-0340, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Mullan
authors.forename: E G
authors.initials: EG
authors.lastname: Wilkins
authors.forename: S
authors.initials: S
authors.lastname: Goldfarb
authors.forename: J C
authors.initials: JC
authors.lastname: Lowery
authors.forename: D M
authors.initials: DM
authors.lastname: Smith
authors.forename: M
authors.initials: M
authors.lastname: Wickman
authors.forename: K
authors.initials: K
authors.lastname: Sandelin
mesh_terms: D001294:Attitude to Health; D019928:Breast Implantation / Q000379:methods; D001943:Breast Neoplasms / Q000208:ethnology / Q000523:psychology / Q000601:surgery*; D002170:Canada / Q000208:ethnology; D003431:Cross-Cultural Comparison; D004644:Emotions; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology*; D008408:Mastectomy; D008603:Mental Health; D011446:Prospective Studies; D011788:Quality of Life; D013524:Surgical Flaps; D013548:Sweden / Q000208:ethnology; D014481:United States / Q000208:ethnology