Determinants of satisfaction with cosmetic outcome in breast cancer survivors: A cross-sectional study

Peh Joo Ho; Mikael Hartman; Danny A Young-Afat; Sofie A M Gernaat; Soo Chin Lee; Helena M Verkooijen

doi:10.1371/journal.pone.0193099

Determinants of satisfaction with cosmetic outcome in breast cancer survivors: A cross-sectional study

PLoS One. 2018 Feb 21;13(2):e0193099. doi: 10.1371/journal.pone.0193099. eCollection 2018.

Authors

Peh Joo Ho¹, Mikael Hartman^{1

2}, Danny A Young-Afat³, Sofie A M Gernaat³, Soo Chin Lee⁴, Helena M Verkooijen³

Affiliations

¹ Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
² Department of Surgery, National University of Singapore, Singapore, Singapore.
³ Imaging Division, University Medical Center Utrecht, Utrecht, The Netherlands.
⁴ National University Cancer Institute, National Health System, Singapore, Singapore.

Abstract

Little research has been done into cosmetic outcomes in non-Western breast cancer populations. We aimed to study the prevalence and determinants of dissatisfaction with cosmetic outcome after breast cancer surgery of Asian breast cancer survivors, and its association with patient-reported anxiety, depression, and quality of life. In a hospital-based cross-sectional study, 384 breast cancer survivors of at least 12 months after diagnosis completed questionnaires on satisfaction with cosmetic appearance, quality of life (EORTC-QLQ-C30) and anxiety and depression (HADS). Cumulative logit models were used to examine the adjusted association between dissatisfaction with cosmetic appearance and demographic and clinical characteristics. Kruskal-Wallis test was used to test for associations between dissatisfaction with cosmetic appearance and patient-reported outcomes. Overall, 20% of women reported to be (very) dissatisfied with cosmetic appearance. Survivors of Chinese ethnicity were more likely dissatisfied with cosmetic appearance compared to Malay survivors (22% and 14% respectively, adjusted OR = 2.4, 95%CI: 1.4-3.9). Women with DCIS (adjusted OR = 2.2, 95%CI: 1.3-3.7) or advanced stage disease (adjusted OR = 2.2, 95%CI: 1.2-3.9) had a higher risk of being dissatisfied with their cosmetic appearance. Women treated with mastectomy were at a higher risk of dissatisfaction with cosmetic appearance (adjusted OR = 1.7, 95%CI: 1.1-2.5). Dissatisfaction with cosmetic appearance was associated with increased depression scores. In this South-East Asian population, one in five breast cancer patients were (very) dissatisfied with the cosmetic outcome of treatment. Chinese women, women with larger tumors and women treated with mastectomy were most likely to report dissatisfaction with cosmetic appearance.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Asian People
Breast Neoplasms / surgery*
Cancer Survivors*
Female
Humans
Mammaplasty*
Middle Aged
Patient Satisfaction*
Quality of Life*
Surveys and Questionnaires*

Grants and funding

The study was carried-out with the support from the National University Hospital, Singapore, Clinician Scientist Award, National Medical Research Council R-608-000-093-511, and Asian Breast Cancer Research Fund N-176-000-023-091 awarded to Mikael Hartman. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.