BREAST RECONSTRUCTION FROM THE PERSPECTIVE OF WOMEN SUBMITTED TO MASTECTOMY: A META-ETNOGRAPHY

The International Awareness of Breast Reconstruction

Background

To our knowledge, this is the first and largest study conducted to collect data among surgeons worldwide about breast reconstruction. We have aimed to collect data about breast reconstruction worldwide, the most popular breast reconstruction techniques, and the barriers behind the low rate of breast reconstruction according to surgeons.

Methodology

A comparative cross-sectional design was used in this study. A prepared questionnaire, which was developed after reviewing the literature review conducted for this study, was used to collect data. The questionnaire is multiple choice. It was distributed among surgeons online.

Results

The study includes 812 participants who live all over the world, representing 79 countries. More than a third of surgeons perform less than 10 breast reconstructions per year (33.38%), and 45.86% of them think that immediate surgery is the most frequent practice. A higher percentage of participants prefer implants over autologous reconstruction as a technique for breast reconstruction (54.9%). Moreover, 39.02% of participants shared that a lack of knowledge about the availability of breast reconstruction was a reason for refusing the surgery.

Conclusions

This study demonstrates that the breast reconstruction rate is still low and that most surgeons prefer implants that are performed immediately. The lack of knowledge among patients about the availability of breast reconstruction is the most common reason for refusing reconstruction. Therefore, there is a need to increase patient awareness about the availability of this surgery.

Micropigmentação Dérmica na Reconstrução do Complexo Aréolo-papilar: Revisão Integrativa da Literatura

Introdução: A micropigmentação dérmica comumente conhecida como tatuagem é uma técnica de reconstrução do complexo aréolo--papilar desde 1986. Objetivo: Identificar na literatura científica evidências sobre a prática de micropigmentação dérmica à reconstrução do complexo aréolo-papilar em mulheres tratadas por câncer de mama. Método: Revisão integrativa com busca nas bases de dados PubMed, SciELO e LILACS. A partir dos critérios de elegibilidade, foram selecionados 14 artigos. A revisão foi relatada segundo os critérios do PRISMA e o nível de evidência classificado segundo o Centro para Medicina Baseada em Evidências de Oxford. Resultados: Na literatura consultada, 71,4% dos estudos são de nível quatro de evidência. Foram sintetizados os achados em quatro categorias: 1) micropigmentação dérmica como método de escolha; 2) período recomendado para realização da micropigmentação; 3) etapas da micropigmentação dérmica; 4) reações esperadas e adversas da micropigmentação. Conclusão: A micropigmentação dérmica é uma técnica que tem proporcionado benefícios psicossociais para as mulheres e oferece à paciente uma aréola com aspecto próximo ao natural, por meio de um procedimento seguro, rápido, raramente doloroso e com baixo risco de complicações, quando garantidas as medidas de biossegurança. As decisões no processo devem ser baseadas por evidências e tomadas em conjunto com as pacientes, respeitando desejos e informando riscos e benefícios.

Improved self-esteem after mat Pilates method intervention in breast cancer women undergoing hormone therapy: randomized clinical trial pilot study

ABSTRACT The purpose of this randomized clinical trial was to analyze the effects of 16 weeks of mat Pilates method intervention in self-esteem and depressive symptoms in women with breast cancer undergoing hormone therapy. Thirty-four women were randomized in Pilates group (PG) (n=18) and control group (CG) (n=16). The intervention occurs for 16 weeks, three times per week for 60 minutes each session (light to very hard intensity according to BORG scale). The CG received three educational sessions and was invited to maintain their routine activities. The data collection took place at the baseline and post-intervention. A questionnaire was applied including Self-Esteem Scale and the Beck Depression Inventory. Anova Two way with repeated measures and Sydak comparison test was used to analyze the effects in the variables after the 16 weeks intervention. Two types of analysis were performed after the intervention, in the analysis by intention to treat PG (n=18) the self-esteem variable showed a significant result (p=0.011) and in the analysis by PG protocol (n=11) (p=0.013). The depressive symptoms did not demonstrate significant improvements after the intervention. Control group did not present any significant changes during the time of the study. The 16 weeks of PG was an effective intervention to improve self-esteem of women with breast cancer undergoing hormone therapy.