“It’s a silver lining”: A template analysis of satisfaction and quality of life following post-mastectomy breast reconstruction

Objective: In the United Kingdom, the number of women undergoing post-mastectomy breast reconstruction is increasing. Consequently, exploring patient-reported outcomes in breast surgery has become increasingly important. This study investigates satisfaction and quality of life following post-mastectomy breast reconstruction.

Design: Qualitative research design.

Methods: In-depth, semi-structured telephone interviews were conducted with 25 women, (Age, M= 53.08, SD=8.41) following breast reconstruction in the United Kingdom. Data were analysed using template analysis which produced three first-level, 13 second-level and 19 third-level themes.
Results: Following reconstruction women reported improved emotional functioning, although this was often accompanied with deterioration in physical, sexual and/or social functioning. Women positively appraised their breast appearance, although some reported a decline in satisfaction over time, attributing this decline to their chosen reconstructive technique. Many women accepted the inevitability of scarring and most perceived their scars as a representation of their journey, signifying survival. Generally women were satisfied with the outcome of their reconstruction, although on reflection some would not have opted for reconstruction. Following breast reconstruction women were increasingly likely to experience the fear of recurrence, attributed to no longer being able to have a mammogram on the affected breast(s).
Conclusions: This study provides new insights into post-mastectomy breast reconstruction and is a novel application of template analysis. The analysis demonstrates only slight variation in some categories of experience among women, despite a heterogeneous sample. The findings allow researchers and clinicians to focus on specific dimensions of satisfaction and quality of life to support the needs of women following reconstruction.