title: Body image and quality of life of breast cancer patients: influence of timing and stage of breast reconstruction.
abstract: The process of cancer-related breast reconstruction is typically multi-staged and can take months to years to complete, yet few studies have examined patient psychosocial well-being during the reconstruction process. We investigated the effects of reconstruction timing and reconstruction stage on body image and quality of life at specific time points during the breast reconstruction process.
  
  
  
  In this cross-sectional study, 216 patients were grouped into four reconstructive stages: pre-reconstruction, completed stage 1, completed stage 2, and final stages. Multiple regression analyses examined the roles of reconstruction timing (immediate vs delayed reconstruction) and reconstruction stage as well as their interaction in predicting body image and quality of life, controlling for patient age, BMI, type of reconstruction, chemotherapy, radiation therapy, and major complication(s).
  
  
  
  A difference in pattern of body image was observed across the reconstructive stages, with those receiving delayed reconstruction showing significant decrease in body image dissatisfaction compared with those with immediate reconstruction. At pre-reconstruction, patients awaiting delayed reconstruction reported significantly lower social well-being compared with those awaiting immediate reconstruction. Reconstruction stage predicted emotional well-being, with higher emotional well-being observed in those who had commenced reconstruction.
  
  
  
  Timing and stage of reconstruction are important to consider when examining psychosocial outcomes of breast cancer patients undergoing reconstruction. Those waiting to initiate delayed reconstruction appear at particular risk for body image, emotional, and social distress. Our findings have implications for delivery of psychosocial treatment to maximize body image and quality of life of patients undergoing cancer-related breast reconstruction.Copyright © 2015 John Wiley & Sons, Ltd.
authors.affiliation: Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.|Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Irene
authors.initials: I
authors.lastname: Teo
authors.affiliation: Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Gregory P
authors.initials: GP
authors.lastname: Reece
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Israel C
authors.initials: IC
authors.lastname: Christie
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Michele
authors.initials: M
authors.lastname: Guindani
authors.affiliation: Department of Biomedical Engineering, The University of Texas at Austin, Austin, TX, USA.|Department of Imaging Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Mia K
authors.initials: MK
authors.lastname: Markey
authors.affiliation: Bariatric & Metabolic Institute, Cleveland Clinic Lerner College of Medicine, Cleveland, OH, USA.
authors.forename: Leslie J
authors.initials: LJ
authors.lastname: Heinberg
authors.affiliation: Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Melissa A
authors.initials: MA
authors.lastname: Crosby
authors.affiliation: Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.|Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Michelle Cororve
authors.initials: MC
authors.lastname: Fingeret
mesh_terms: D000328:Adult; D000368:Aged; D001828:Body Image / Q000523:psychology*; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology*; D008408:Mastectomy / Q000379:methods / Q000523:psychology*; D008875:Middle Aged; D011788:Quality of Life; D013997:Time Factors; D016896:Treatment Outcome