Post-mastectomy breast reconstruction wound healing and the association of perceived stress and serum cortisol levels

Background: Post-mastectomy breast reconstruction for breast cancer can bring about changes in body image. Scarring, or wound healing, is considered a form of bodydisfigurement and is associated with psychosocial difficulties, including areas of body imageand quality of life. The aim of this study is to demonstrate the relationships betweenobjective and subjective wound healing, between objective wound healing and serumcortisol levels, and between perceived stress and serum cortisol levels in womenundergoing post-mastectomy breast reconstruction.Methods: Nineteen women undergoing post-mastectomy breast reconstruction wererecruited to a pilot study. At one week prior, one week after, and one month after surgery,participants completed fifteen saliva samples at each time-point as well as measures forpsychosocial factors, including stress (PSS) and subjective wound healing. Objective measurement of wound healing was conducted at three to eight weeks post-surgery using the EPISCAN, a high frequency ultrasound imaging system. Serum cortisol levels analysed with salivary cortisol enzyme immunoassay.Findings: A Pearson‘s correlation was computed to assess the relationship between perceived stress and subjective wound healing of the reconstructed breast(s) at one month post-surgery. There was a positive correlation between the two variables, r = 0.530, n =13, p = 0.031.Discussion: This output is significant in its combination of multiple methodologies to address the research aims; this output will add new knowledge that will contribute to the understanding of how women heal after a breast reconstruction and how the role psychosocial difficulties may play in wound healing.