• Sarah H Kennedy, Mahteme Bekele, Nicholas L Berlin, Kavitha Ranganathan, Jennifer B Hamill, Etsehiwot Haileselassie, Joseph Oppong, Lisa A Newman, and Adeyiza O Momoh.
• Section of Plastic Surgery, Department of Surgery, University of Michigan Medical School, Ann Arbor, MI.
• Ann. Surg. 2023 Nov 1; 278 (5): e1080e1086e1080-e1086.

ObjectiveAssess quality of life and mental health implications of mastectomy for breast cancer on sub-Saharan African women.BackgroundMortality rates amongst women diagnosed with breast cancer in sub-Saharan Africa (SSA) are high, with disparities in survival relative to women in high income countries partly attributed to advanced disease at presentation. Fears of the sequelae of mastectomy are a prominent reason for presentation delays. There is a critical need to better understand the effects of mastectomy on women in SSA to inform preoperative counseling and education for women with breast cancer.MethodsWomen with breast cancer in Ghana and Ethiopia undergoing mastectomy were followed prospectively. Breast related quality-of-life and mental health measures were evaluated preoperatively, 3 and 6 months postoperatively, using BREAST-Q, PHQ-9, and GAD-7. Bivariate and logistic regression analyses evaluated changes in these measures for the total cohort and between sites.ResultsA total of 133 women from Ghana and Ethiopia were recruited. The majority of women presented with unilateral disease (99%) and underwent unilateral mastectomy (98%) with axillary lymph node dissection. Radiation was more common in Ghana ( P <0.001). Across most BREAST-Q subscales, women from both countries reported significantly decreased scores at 3 months postoperative. At 6 months, the combined cohort reported decreased scores for breast satisfaction (mean difference, -3.4). Women in both countries reported similar improvements in anxiety and depression scores postoperatively.ConclusionsWomen from Ghana and Ethiopia who underwent mastectomy experienced a decline in breast-related body image while also experiencing decreased levels of depression and anxiety.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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