Mastectomy Associated with Declines in Sexual Health and Body Image Post-Surgery

Recent research highlights that while mastectomy remains a vital and potentially life-saving procedure for numerous women diagnosed with breast cancer, it can adversely affect sexual health and body image after the surgery. This assertion is based on a systematic review examining the postoperative effects of mastectomy on women with breast cancer, which will be showcased at the upcoming American College of Surgeons (ACS) Clinical Congress 2025 in Chicago from October 4 to 7.

Medical professionals emphasize the significance of pre-surgical screening to prepare women for the diverse physical and emotional challenges that may follow a mastectomy. It is noted that surgeons frequently prioritize the medical aspects of treatment without providing comprehensive counseling regarding the full spectrum of potential outcomes, both physical and psychological, that may arise post-surgery.

Mastectomy, involving the removal of one or both breasts, is a significant surgical intervention that necessitates ongoing follow-up care. Approximately 25% of breast cancer patients undergo this procedure, with many experiencing shorter hospital stays after surgery, prompting researchers to delve into the long-term outcomes associated with mastectomy.

From nearly 3,000 studies reviewed, researchers focused on 20 that met specific criteria, investigating the impacts of mastectomy on quality of life, sexual health, and overall psychosocial well-being. The studies were restricted to women diagnosed with stages 1 to 3 breast cancer, thereby excluding those with advanced-stage cancer or those opting for prophylactic mastectomy due to cancer risk.

Key Findings:

• Psycho-Social Outcomes: Out of the analyzed studies, 15 reported negative psychosocial outcomes for women post-mastectomy in at least one area of psychosocial health.
• Lack of Standardization: The research identified 38 different patient-reported outcome measures across the 20 studies, illustrating a lack of consistency in assessing post-surgical quality of life. Commonly evaluated areas included body image (55%), sexual health (50%), pain or physical function (45%), and overall quality of life (40%). However, fewer studies addressed psychosocial health (35%) and patient satisfaction (25%).
• Need for Standardized Assessment: A majority of the reported outcome measures were applied only once in the studies (72%), indicating a need for a standardized approach to better prepare women for the realities of mastectomy. Researchers advocate for the development of validated screening tools to assess the readiness of women prior to undergoing the procedure.

As survival rates for breast cancer improve, the focus on quality of life outcomes for survivors becomes increasingly crucial. The study acknowledges limitations due to the variability in quality and design of the included research, making definitive conclusions challenging. Future investigations will aim to create reliable assessment tools to evaluate the preparedness of women facing mastectomy.