Indian Journal of Surgery

, Volume 81, Issue 1, pp 43–50 | Cite as

Breast Reconstruction Affects Coping Mechanisms in Breast Cancer Survivors

  • Blossom LakeEmail author
  • Heidi R Fuller
  • Sarah Rastall
  • Tamoor Usman
Original Article


Coping strategies used by women with breast cancer are vital for adjustment to their disease. Whilst it is clear that factors such as age at diagnosis, social support and ethnicity can influence coping mechanisms, there is currently no information about whether breast reconstruction changes mechanisms of coping for such patients. The aims of this study, therefore, were to determine how women who have had immediate breast reconstruction and mastectomy cope, compared to those who have mastectomy alone, and whether there are differences in coping mechanisms due to breast reconstruction surgery. This was a retrospective cohort study, using a standardised questionnaire called the Brief Cope Scale. Inclusion criteria was the following: all women who had immediate breast reconstruction and mastectomy in Shropshire from 2003 to 2014 for ductal carcinoma in situ or node-negative invasive breast cancer. Each patient was matched for year of diagnosis, adjuvant therapy and age to one woman who had mastectomy alone. Two hundred thirty-four questionnaires were sent with a 58% response rate. Significantly more patients from the reconstruction cohort coped by active coping (T value 1.66, P value 0.04) compared to those in the mastectomy alone cohort. In contrast, significantly more patients in the mastectomy alone cohort coped by active venting compared to the reconstruction cohort (T value 1.71, P value 0.04). This study indicates for the first time that breast reconstruction may alter coping mechanisms in breast cancer survivors. Awareness of these coping mechanisms will enable clinicians to provide appropriate, individualised support.


Breast reconstruction Breast cancer Survivors Coping behaviour Defence mechanisms 



British Association Surgical Oncology


Ductal carcinoma in situ


Quality of life


Shrewsbury and Telford NHS Trust



All funding for this project was provided by lead author Blossom Lake. All the finance for this project was provided by the Chief Investigator. Keele University provided the insurance for this research project.

Compliance with Ethical Standards

This cohort study had the full approval of the National Research Ethic Committee Wales REC4 Reference No. 14/WA/1174.

Conflicts of Interest

The authors declare that they have no conflicts of interest.


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Copyright information

© Association of Surgeons of India 2017

Authors and Affiliations

  1. 1.Shrewsbury & Telford NHS Trust, Princess Royal Hospital, Apley CastleTelfordUK
  2. 2.School of Postgraduate MedicineKeele UniversityKeeleUK

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