Coping in Post-Mastectomy Breast Cancer Survivors and Need for Intervention: Systematic Review

BACKGROUND: Breast cancer is the most prominent cancer type to affect women. Surgical treatment of invasive breast cancers involves mastectomy. Due to mastectomy, women are subjected to social, emotional, and cultural problems which need to be addressed. OBJECTIVE: The objective of the study is to understand how women cope with body image–related issues, trauma, anxiety, and depression post-mastectomy. DESIGN: A systematic literature review was conducted for understanding the coping in post-mastectomy patients. The methods for identifying the studies were based on Preferred Reporting Items for Systematic reviews and Meta-analysis (PRISMA) guidelines. DATABASES: Medline/PubMed, PsycInfo, and Cochrane databases were used for searching relevant articles. A final of 19 studies were analyzed for the work. METHODS: Search strings such as “coping strategies and post mastectomy,” “body image coping and post mastectomy” and “anxiety coping and post mastectomy” were used for identification of references from databases. Eligibility criteria were used for finalizing the references. RESULTS: Analysis of the 19 studies has clearly shown that women who undergo mastectomy suffer from anxiety, stress, and trauma. This study has observed that women have problems with their body image post-mastectomy along with bouts of depression. Self-coping has been observed in relatively few studies. Psychological interventions before surgery have been observed to be a better coping strategy. In most of the studies, women opted for breast reconstruction to overcome the trauma associated with mastectomy. CONCLUSION: Mastectomy has a severe impact on women’s appearance and psychology. Breast reconstruction and acceptance have played an important role in coping among these women. However, breast reconstruction is not accepted by many women due to a multitude of factors. Thus, it is essential to have proper intervention programs in place to ensure women can cope with this situation and can lead healthy lives. REGISTRATION: Systematic literature review (SLR) is submitted to PROSPERO. The application confirmation number is 449135. Registration awaited from the database.