Background: Reconstruction after mastectomy has become an integral part of breast cancer treatment. The effects of psychological factors on quality of life after reconstruction have been poorly investigated. The authors examined clinical and personality characteristics related to quality of life in patients receiving reconstructive surgery.
Methods: All patients received immediate reconstruction and were evaluated in the week before tissue expander implantation (T0) with a semistructured interview for demographic and clinical characteristics, the Temperament and Character Inventory, the Inventory of Interpersonal Problems, the Short Form Health Survey, the Severity Item of the Clinical Global Impression, the Hamilton Depression Rating Scale, and the Hamilton Anxiety Rating Scale. Assessment with the Short Form was repeated 3 months after expander placement (T1). Statistics were calculated with univariate regression and analysis of variance. Significant variables were included in a multiple regression analysis to identify factors related to the change T1–T0 of the mean of the Short Form–transformed scores. Results were significant when p was less than or equal to 0.05.
Results: Fifty-seven women were enrolled. Results of multiple regression analysis showed that the Temperament and Character Inventory personality dimension harm avoidance and the Inventory of Interpersonal Problems domain vindictive/self-centered were significantly and independently related to the change in Short Form mean score.
Conclusions: Personality dimensions and patterns of interpersonal functioning produce significant effects on patients' quality of life during breast reconstruction. Patients with high harm avoidance are apprehensive and doubtful. Restoration of body image could help them to reduce social anxiety and insecurity. Vindictive/self-centered patients are resentful and aggressive. Breast reconstruction could symbolize the conclusion of a reparative process and fulfill the desire of revenge on cancer.
From the Service for Personality Disorders, Unit of Psychiatry 1, and the Clinical Methodology Unit, Department of Neurosciences, and the Service for Plastic and Reconstructive Surgery, Unit of Plastic Surgery, Department of Medicine and Surgery, University of Turin.
Received for publication December 4, 2009; accepted June 22, 2010.
Disclosure: No funds were received to perform the present investigation. The authors do not have any financial interest in the topics or in the results.
Silvio Bellino, M.D.; Service for Personality Disorders; Unit of Psychiatry 1; Department of Neurosciences; University of Turin; Via Cherasco 11; 10126 Turin, Italy; email@example.com