title: Physical therapy after prophylactic mastectomy with breast reconstruction: a prospective randomized study.
abstract: BACKGROUND
  The rate of prophylactic mastectomies (PM) is increasing. Patients generally report high levels of health related quality of life and satisfaction after the procedure, whereas body image perception and sexuality may be negatively affected. The aim of the study was to evaluate the interest in physical therapy as a means of improving body image and sexuality in women after PM.
  
  
  METHODS
  Patients undergoing PM at Karolinska University Hospital between 2006 and 2010 were eligible. The following patient-reported outcome measures were used at study baseline and 2 years postoperatively: the body image scale (BIS), the sexual activity questionnaire (SAQ), the short-form health survey (SF-36), the hospital anxiety and depression scale (HAD), and a study specific "pain/motion/sensation scale".
  
  
  RESULTS
  Out of 125 patients invited to participate in this prospective randomized study, 43 (34%) consented and were randomized into the intervention (n = 24, 56%) or control (n = 19, 44%) groups. There were no statistically significant between-group differences found with respect to BIS, SAQ, SF-36, HAD, and "pain/motion/sensation". Two years postoperatively, more than half of the patients in both groups reported problems like feeling less attractive, less sexually attractive, their body feeling less whole, and being dissatisfied with their body. A majority marked a decreased sensation in breast area.
  
  
  CONCLUSIONS
  The interest in a physiotherapy intervention was limited among women who had undergone PM. The intervention did not show any substantial effects. A large proportion of patients reported specific body image related and pain/motion/sensation problems postoperatively.
authors: Department of Oncology-Pathology, Karolinska Institutet, SE-17176 Stockholm, Sweden. Electronic address: dmytro.unukovych@ki.se.
authors: Dmytro
authors: D
authors: Unukovych
authors: Department of Oncology-Pathology, Karolinska Institutet, SE-17176 Stockholm, Sweden.
authors: Hemming
authors: H
authors: Johansson
authors: The Swedish Cancer Society, Cancerfonden, David Bagares Gata 5, 10155 Stockholm, Sweden.
authors: Elizabeth
authors: E
authors: Johansson
authors: Department of Oncology-Pathology, Karolinska Institutet, SE-17176 Stockholm, Sweden; Department of Oncology, Radiumhemmet, Karolinska University Hospital, SE-17176 Stockholm, Sweden.
authors: Brita
authors: B
authors: Arver
authors: Department of Oncology-Pathology, Karolinska Institutet, SE-17176 Stockholm, Sweden; Department of Oncology, Radiumhemmet, Karolinska University Hospital, SE-17176 Stockholm, Sweden.
authors: Annelie
authors: A
authors: Liljegren
authors: Department of Oncology-Pathology, Karolinska Institutet, SE-17176 Stockholm, Sweden.
authors: Yvonne
authors: Y
authors: Brandberg
mesh_terms: D000328:Adult; D001007:Anxiety / Q000523:psychology; D001828:Body Image / Q000523:psychology*; D001943:Breast Neoplasms / Q000517:prevention & control*; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology / Q000534:rehabilitation*; D008408:Mastectomy / Q000523:psychology / Q000534:rehabilitation*; D008875:Middle Aged; D026741:Physical Therapy Modalities; D011788:Quality of Life / Q000523:psychology*; D019529:Sexuality / Q000523:psychology*; D016896:Treatment Outcome
keywords: Breast cancer; PROMs; Physical therapy; Prophylactic mastectomy; Quality of life; Randomized