Abstract P6-12-15: The psychosocial impact of surgical scars in survivorship: Findings from a nationwide survey of women breast cancer survivors
Authors: Gass JS , Mitchell S , Hanna M 
Published: February 2018

Abstract
Background: Surgery is an integral component of comprehensive breast cancer therapy, but leaves physical scars that may have psychosocial consequences in survivorship. Previous studies have shown that breast cancer treatment has a negative impact on body image, sexual function, mental health and social adjustment. As overall survival from early staged breast cancer approaches 99%, more data is needed on the late and long term consequences of breast cancer treatment and quality of life in survivorship. The aim of this research was to explore how women are affected specifically by physical scars from breast cancer surgery.
Methods: A nationwide internet survey was conducted among women who reported being surgically treated by lumpectomy only (n=215), mastectomy only (n=140), or both procedures (n=132) for breast cancer. To improve generalizability, census-based enrollment quotas were applied for geographic region, health insurance, and income.
Results: A solid majority of women in each of the three study groups agreed somewhat or strongly that they “do not like the location of my surgical scar” (table 1). Younger women were more likely to agree strongly with that statement (table 2).
Results for the Main Outcome, “I do not like the location of my surgical scar”. n%Lower 95% CIUpper 95%CILumpectomy only (n=215) Agree strongly43201525Agree somewhat94443850Disagree somewhat46211627Disagree strongly32151121 Mastectomy only (n=140) Agree strongly46332441Agree somewhat47342642Disagree somewhat33241631Disagree strongly1410515 Both surgeries (n=132) Agree strongly31241731Agree somewhat89675875Disagree somewhat108413Disagree strongly2204
Table 2. Regression Analyses for Strong Agreement with the Statement, “I do not like the location of my surgical scar”. ORlower 95% CIUpper 95% CIpLumpectomy only (n=215) Age (years)0.960.940.9990.010Significant Other2.30.866.30.098Income0.90.71.20.5College Graduate0.70.31.80.5 Mastectomy Only (n=140) College Graduate0.30.10.70.006Age0.970.940.990.04Income0.80.61.20.4Significant Other1.20.62.70.6 Both Surgeries (n=132) College Graduate155.044&lt;0.001Significant Other0.60.21.90.4Age0.990.941.030.5
In each of the three study groups, the majority of women agreed that they did not realize how uncomfortable the scars would make them feel when undressed or when seen undressed by someone else. The majority of women in each of the three study groups also felt self-conscious some or all of the time due to the surgical scars and avoided certain pieces of clothing some or all of the time because they revealed the scars.
Conclusion: Consistent with previous literature, this survey shows that surgical scars from lumpectomy and mastectomy are not merely “cosmetic” but have a substantial impact on the lives and well-being of women in survivorship. Surgeons may be able to improve the breast survivorship journey for women buy employing techniques that minimize visibility of surgical scars. Efforts to minimize the iatrogenic impact of surgery and provide comprehensive care may ensure good psychosocial survivorship.
Citation Format: Gass JS, Mitchell S, Hanna M. The psychosocial impact of surgical scars in survivorship: Findings from a nationwide survey of women breast cancer survivors [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P6-12-15.