Review finds varied measures of psychosocial outcomes after mastectomy

Researchers searched three databases for studies published from 1997 through October 2024 that assessed psychosocial outcomes after mastectomy for early-stage breast cancer. Twenty studies met the inclusion criteria; most were single-institution, cross-sectional studies. Across 15 studies, investigators used 38 different patient-reported outcome measures, most of which appeared in only one study. The review identified seven domains: quality of life, sexual health or function, body image, mental health, pain or physical health, psychosocial health, and satisfaction.

Compared with mastectomy, breast-conserving surgery was associated with better body image in 67% of studies and better physical health in 38%, as well as improved psychosocial outcomes and satisfaction. Reconstruction improved, but did not eliminate, these differences. The authors highlight the need to prepare patients for the potential psychosocial effects of mastectomy and to develop tailored support. Findings are limited by the varied measures used and the predominance of cross-sectional, single-institution studies; most studies reporting race included more than 80% White participants, limiting representation. The review does not establish that any particular support strategy improves outcomes.