Depression and Body Image Distress Following Mastectomy With Reconstruction

Study Overview
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Brief Summary
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Mastectomy is a major surgery that can have a profound effect on women's psychosocial wellbeing, including elevated depression and body image distress. Reconstructive breast surgery aims to improve patients' psychosocial adjustment to mastectomy, yet for some women substantial distress persists after reconstruction. However, very little is known about risk or protective factors for persistent depression or body image distress following mastectomy with reconstruction. The present study aims to address this critical gap. In women undergoing mastectomy with breast reconstruction, the investigators will assess risk and protective factors for post-surgery depression severity and body image distress.

Official Title
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Risk and Protective Factors for Depression and Body Image Distress Following Mastectomy With Breast Reconstruction

Conditions
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Breast Cancer, BRCA1 Mutation, BRCA2 Mutation

Intervention / Treatment
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* Other: Psychosocial variables


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Female adults (age 18+) who are scheduled for mastectomy with immediate breast reconstruction at the Massachusetts General Hospital (MGH) Plastic and Reconstructive Surgery Program English language proficiency Ability to provide informed consent. Exclusion Criteria: Current psychotic disorder, manic episode, serious neurological disorder, intellectual disability, or developmental disorder Current active suicidal ideation Current treatment plan includes radiation and/or ongoing chemotherapy Does not have access to Internet at home, required to complete study questionnaires

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Breast reconstruction patients<br>Self-reported psychosocial variables and a clinical interview assessing mental health history will be administered prior to participants' scheduled mastectomy and breast reconstruction surgery (which is part of their routine medical care for cancer treatment or prevention). Follow up self-report measures will be collected after the surgery as well. | Other: Psychosocial variables<br>* The investigators will assess mental health history and self-reported psychosocial variables as hypothesized risk and protective factors for body image and depression severity in breast reconstruction patients, before and after their mastectomy and breast reconstruction surgery. Mastectomy and breast reconstruction will be received in the context of routine medical care. Thus, this is not a psychological intervention, but rather observational measures assessed pre- and post routine care for breast reconstruction patients.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Body Image Scale (BIS) | Assesses severity of body image distress related to breast cancer treatment with a summed total score, which ranges from 0 (no body image distress) to 30 (substantial body image distress). | 2-3 months post-surgery (i.e., Time 2) | 
| Beck Depression Inventory-II (BDI-II) | Assesses severity of depressive symptoms with a summed total score, which ranges from 0 (no depressive symptoms) to 63 (severe depressive symptoms). | 2-3 months post-surgery (i.e., Time 2) | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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breast reconstruction, mastectomy