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Striving for completeness: Women's long-term experiences of living with a reconstructed breast after breast cancer -
Susanne Ahlstedt Karlsson1, Clary Andrade2, Linda Myrin-Westesson3
1Department of Plastic Surgery, Sahlgrenska University Hospital, Region Västra Götaland, Bla Straket 3, Gothenburg, SE-413 45, Sweden; Institute of Health and Care Sciences, Sahlgrenska Academy, University of Gothenburg, Box 547, Gothenburg, SE-405 30, Sweden; Department of Plastic Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 3, Gothenburg, SE-413 90, Sweden.
Purpose:
Breast reconstruction is often evaluated as a surgical outcome, despite evidence that bodily adjustment and satisfaction evolve over time. Existing research mainly focuses on short-term outcomes, providing limited insight into women's long-term lived experiences and implications for oncology nursing practice. This study aimed to explore women's experiences of living with a reconstructed breast 7-8 years after breast cancer surgery, focusing on how satisfaction, bodily perception, and meaning are negotiated over time.
Methods:
A descriptive qualitative design was used, applying inductive content analysis according to Elo and Kyngäs (2008). An extreme-case purposive sampling strategy captured contrasting long-term experiences, including women from the lowest and highest quartiles of the BREAST-Q Satisfaction with breast domain. Sixteen semi-structured interviews were conducted between September 2022 and June 2023. Trustworthiness was enhanced through investigator triangulation, iterative coding, and peer debriefing. The study followed SRQR guidelines. Ethical approval was obtained, and written informed consent was provided.
Results:
The analysis yielded the overarching category "Striving for bodily completeness", reflecting women's ongoing efforts to integrate the reconstructed breast into their bodily self-image. Satisfaction emerged as dynamic and ambivalent, characterised by the coexistence of acceptance and dissatisfaction. Women described how aesthetic outcomes, altered sensory experiences, and perceived bodily incongruence shaped long-term adjustment. Social interactions with partners, children, and clinicians further influenced interpretation and valuation of the reconstructed breast.
Conclusion:
Breast reconstruction should be understood as a long-term process of bodily reconciliation rather than a discrete surgical outcome. For nursing, this highlights the importance of sustained, individualised follow-up.