Breast Asymmetry Affects Quality of Life

Pronounced Breast Asymmetry After Lumpectomy Raises Risk of Depression Symptoms

By Kelley Colihan
WebMD Health News

Reviewed By Louise Chang, MD

July 9, 2008 — A new study shows that women who get breast conserving surgery, or lumpectomy, to treat breast cancer are more likely to have depression symptoms and worse quality of life if there is pronounced breast asymmetry after surgery.

Breast cancer patients are the largest group of cancer survivors in the U.S., according to a background report that was published alongside the study.

The study was led by Jennifer Waljee, MD, and colleagues at the University of Michigan in Ann Arbor.

Researchers surveyed 714 women who had breast-conserving surgery at the University of Michigan Medical Center from 2002 to 2006.

They were asked to rate how they were doing in these areas after surgery:

• Quality of life
• Whether they had symptoms of depression
• Fear of recurrence
• Whether they felt stigmatized
• Whether they perceived a change in their health status

Here are the results:

• Nearly a third of women who had breast-conserving surgery reported having "pronounced" asymmetry of their breasts after surgery.
• Women with pronounced asymmetry in their breasts were 4.5 times more likely to feel stigmatized because of their cancer treatment. They were also less likely to report unchanged health status or that their health had improved after the treatment.
• Women who had minimal breast asymmetry reported higher quality-of-life scores than women with pronounced breast asymmetry after surgery.
• Women with pronounced breast asymmetry were more likely to have symptoms of depression; 34% of women with pronounced asymmetry had symptoms of depression, compared with 16% and 18% of those with minimal and moderate breast asymmetry, respectively.

Women with pronounced breast asymmetry were twice as likely to fear that cancer would recur when compared with those with minimal asymmetry.

Breast Asymmetry Affects Quality of Life

"We found that one of the most important factors of post-operative quality of life and satisfaction was post-operative asymmetry or the aesthetic outcome that women experienced after their surgery," Waljee says in a news release.

Waljee says that "It's important for women to think about all of those issues at the time that they're making their surgical decision and realize that although breast conserving surgery may or may not be less disfiguring than mastectomy, they're likely to experience some asymmetry afterwards that may impact their quality of life."

She hopes the findings can help lead to improved care for breast cancer patients. "It's important for breast surgeons to have an open and honest dialog with their patients so that they understand patients' expectations before surgery and can better address post-operative recovery needs."

The American Cancer Society reports that 182,460 women in the U.S. will be diagnosed with invasive breast cancer this year and 40,480 will die from the disease.

The results appear in the July 10 edition of the Journal of Clinical Oncology.

SOURCES: Waljee, J. Journal of Clinical Oncology, July 10, 2008; vol 26: pp 3331-3337. News release, University of Michigan. American Cancer Society.

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