A Prospective Evaluation of the Quality of Life and Mental Health Implications of Mastectomy Alone on Women in sub-Saharan Africa.

Journal: Annals of surgery

Volume: 278

Issue: 5

Year of Publication: 2023

Affiliated Institutions:  Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI. Department of Surgery, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia. Division of Plastic Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana. Department of Surgery, Weill Cornell Medicine, New York, NY.

Abstract summary 

Assess quality of life and mental health implications of mastectomy for breast cancer on sub-Saharan African women.Mortality rates amongst women diagnosed with breast cancer in sub-Saharan Africa (SSA) are high, with disparities in survival relative to women in high income countries partly attributed to advanced disease at presentation. Fears of the sequelae of mastectomy are a prominent reason for presentation delays. There is a critical need to better understand the effects of mastectomy on women in SSA to inform preoperative counseling and education for women with breast cancer.Women with breast cancer in Ghana and Ethiopia undergoing mastectomy were followed prospectively. Breast related quality-of-life and mental health measures were evaluated preoperatively, 3 and 6 months postoperatively, using BREAST-Q, PHQ-9, and GAD-7. Bivariate and logistic regression analyses evaluated changes in these measures for the total cohort and between sites.A total of 133 women from Ghana and Ethiopia were recruited. The majority of women presented with unilateral disease (99%) and underwent unilateral mastectomy (98%) with axillary lymph node dissection. Radiation was more common in Ghana ( P <0.001). Across most BREAST-Q subscales, women from both countries reported significantly decreased scores at 3 months postoperative. At 6 months, the combined cohort reported decreased scores for breast satisfaction (mean difference, -3.4). Women in both countries reported similar improvements in anxiety and depression scores postoperatively.Women from Ghana and Ethiopia who underwent mastectomy experienced a decline in breast-related body image while also experiencing decreased levels of depression and anxiety.

Authors & Co-authors:  Kennedy Sarah H SH Bekele Mahteme M Berlin Nicholas L NL Ranganathan Kavitha K Hamill Jennifer B JB Haileselassie Etsehiwot E Oppong Joseph J Newman Lisa A LA Momoh Adeyiza O AO

Study Outcome 

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Statistics
Citations :  Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359 86.
Authors :  9
Identifiers
Doi : 10.1097/SLA.0000000000005891
SSN : 1528-1140
Study Population
Women
Mesh Terms
Female
Other Terms
Study Design
Cohort Study,Cross Sectional Study
Study Approach
Country of Study
Ghana
Publication Country
United States