Calidad de vida y satisfacción en la mujer con reconstrucción mamaria inmediata tras mastectomía por cáncer

Abstract

Porpouse. The aim of the study was to analyse satisfaction and quality of life after immediate breast reconstruction due to cancer and its determining factors. Method. An ambispective design was used(n=101; α=0.05; precision=10%), studying anthropometric, cultural ,social and clinic data, together with the results from a Fagerström test, Charlson comorbidity index and the BREAST-Q© questionnaire. Informed consent and approval from an ethical review board was obtained (code 2013/253). A logistic regression analysis was performed in order to identify variables associated with quality of life and satisfaction. Results. Mean age on diagnosis was 44.87 ± 8.5 years. A skin-sparing mastectomy was carried out (42.7%) and reconstruction using an implant (74.5%). The domain on the BREAST-Q© for quality of life with the lowest score was sexual well-being (61.5). The satisfaction domain with the lowest score was with the breast (59) and the highest score was health care (100). The variables associated with the worst quality of life in the physical wellbeing chest were the skin-sparing mastectomy (OR=4.2) and lymphedema (OR=12.9). Antibody treatment was associated with a worse score on the psychosocial (OR=4.25) and sexual (OR=7.34) well-being. Satisfaction was associated with nicotine dependence on the breast and outcome scale. The higher the dependence on nicotine, the greater the dissatisfaction with the breast (OR=2.41) and with the outcome (OR=2.45). The lower satisfaction with the information was associated with nipple skin-sparing mastectomy (OR=4.21). Satisfaction with the surgeon increased with age (OR=0.93) (p=0.07), and higher level of education (OR=0.07). Satisfaction with nursing staff care was greather if women had doctor/degree study (OR=0.09), breast implant reconstruction (OR=0.13) and hormonal treatment (OR=0.13). Lower satisfaction with nursing care was associated with anxiolytics treatmet (OR=5.65) (p=0.06). Conclusions. The type of treatments and lymphedema modify the patients’ quality of life. Satisfaction with breast reconstruction is associated with nicotine dependency. Satisfaction with care is associated with treatments, and the patient’s socio-demographic variables.