20 Dec Breast Asymmetry Negatively Impacts Adolescent Psychological Health
MedicalResearch.com Interview with:
Brian I. Labow, MD
Director, Adolescent Breast Clinic
Assistant in Surgery Assistant Professor of Surgery
Harvard Medical School Primary
Medical Research: What is the background for this study? What are the main findings?
Dr. Labow: This study is part of our larger Adolescent Breast Disorder Study, in which we examine the impact of several breast disorders on adolescent girls and boys and measure the effect of treatment. In this present study we have found breast asymmetry, defined as having at least 1 cup size difference between breasts, can have a significant impact on the psychological wellbeing of adolescent girls. Validated surveys were given to adolescent girls with breast asymmetry, macromastia (enlarged breasts), and healthy unaffected girls between the ages of 12-21 to assess a wide array of health domains. Girls with breast asymmetry had noted deficits in psychological wellbeing and self-esteem when compared to healthy girls of the same age. These impairments were similar to those of girls with macromastia, a condition known to have significant negative mental health effects. Interestingly, these negative psychological outcomes did not vary by patient’s age or severity of breast asymmetry. Older and younger adolescents were negatively impacted similarly, as were those with lesser and greater degrees of breast asymmetry.
Medical Research: What should clinicians and patients take away from your report?
Dr. Labow: Clinicians and patients should be aware that although breast asymmetry has historically been viewed as a common cosmetic issue, it has the potential to negatively affect adolescent girls’ quality of life, specifically their psychological health and self-esteem. Early intervention may alleviate these associated impairments. Although surgery may be appropriate for older patients, intervention for the adolescent can include consultation, support, and the use of breast prostheses.
The considerable barrier to care for young women with breast asymmetry must also be addressed. Although the Women’s Health and Cancer Rights Act of 1998 guarantees a woman’s right to insurance coverage to treat both the affected and unaffected breast, no such federal provision is made for younger women with congenital differences in breast size. As a result treatment for adolescent breast asymmetry is often not covered by insurance, citing “no functional impairment.” We hope our study dispels these misconceptions and draws attention to the very real psychological impairment breast asymmetry can have on the adolescent.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Labow: Our study has confirmed the negative psychological effects of breast asymmetry in adolescents, but no study has sought to examine how these deficits improve after intervention, both surgical and non-surgical. Research by my group is currently underway to assess how intervention may improve the quality of life of young women with breast asymmetry.
Citation:
Plastic & Reconstructive Surgery: December 2014 – Volume 134 – Issue 6 – p 1116–1123
doi: 10.1097/PRS.0000000000000736
Last Updated on March 27, 2015 by Marie Benz MD FAAD