Connect with us

Wellness

Online tool supports decisions about breast reconstruction after mastectomy

Published

on

 For women with breast cancer undergoing mastectomy, an online decision aid can help in making informed decisions regarding immediate breast reconstruction (IBR).

Breast reconstruction for women undergoing mastectomy can improve psychosocial outcomes such as body image and sexual functioning. Among the complex decisions facing these patients is whether to undergo breast reconstruction immediately after mastectomy or at a later time, or not to have reconstruction. Rates of IBR have increased in recent years, although considerable variations remain.

Patient decision aids (pDAs) are tools to support the process of shared decision making between patients and doctors. Although pDAs have been shown to reduce decisional conflict for a range of treatment decisions, “there are limited interventions to support patient decision making about breast reconstruction available, particularly when the healthcare context is considered,” the researchers of the new randomised trial write.

“In our study, use of a patient decision aid helped women feel better prepared to discuss their options on whether or not to undergo IBR with the plastic surgeon,” comments Eveline M.A. Bleiker, PhD, of Netherlands Cancer Institute, Antoni van Leeuwenhoek, Amsterdam.

Professor Bleiker and colleagues evaluated a newly developed pDA to support informed decision-making about IBR.

The study included 250 patients with breast cancer scheduled for mastectomy at eight Dutch centres. Patients were randomly assigned to receive the online pDA or a standard informational leaflet.

The pDA provided evidence-based information on breast reconstruction options and support in clarifying patients’ personal values affecting their treatment decision. On completing the pDA, patients received a summary sheet including their breast reconstruction preferences.

Women using pDA ‘feel better prepared for decision making’

The two groups were compared on measures of decisional conflict – uncertainty about choosing between competing options – and other aspects of the decision-making process. Nearly all patients assigned to the pDA used the online tool; just over half discussed their summary sheet with the plastic surgeon.

With either the pDA or informational leaflet, decisional conflict decreased over time. In both groups, about 13 per cent of patients had clinically significant decisional conflict.

Women assigned to the decision aid “reported feeling better prepared for decision making than those in the control group,” the researchers write.

Other assessments were similar between groups, including shared decision making and satisfaction with breast reconstruction information.

Knowledge increased in both groups, with no difference in decision regret. With either source of information, about 70 per cent of women opted for IBR.

“Our findings indicate that both the online pDA and the information leaflet are helpful for breast cancer patient having to make a decision about IBR,” Bleiker and co-authors write.

“The online format of the pDA more easily allows for adaptions required by future developments in breast reconstruction options and scientific evidence, and for the further tailoring of information to patients’ personal situation and information needs.”

Publication of the new study is timed to coincide with Breast Cancer Awareness Month and Breast Reconstruction Awareness Day.

Celebrated October 16 this year, “BRA Day” is designed to educate women about post-cancer breast reconstruction options and outcomes – including the federal requirement for insurance coverage for breast reconstruction surgery.

BRA Day events worldwide bring attention to the varied options and procedures available plus give information to patients and their supporters so they can make informed decisions about their care.

The research has been published in the journal Plastic and Reconstructive Surgery.

Mental health

Fear of ageing may age women faster, study suggests

Published

on

Ageing anxiety may accelerate biological ageing in women, with fears about worsening health linked to faster epigenetic ageing, according to new research.

The study found that greater anxiety about growing old was associated with accelerated epigenetic ageing, as measured by the DunedinPACE clock, based on biological markers in blood samples.

Epigenetic changes are shifts in how genes are switched on or off without altering DNA itself, which can influence how the body ages and functions.

“Our research suggests that subjective experiences may be driving objective measures of ageing,” said Mariana Rodrigues, a PhD student and the first author of the study.

“Ageing-related anxiety is not merely a psychological concern, but may leave a mark on the body with real health consequences.”

Researchers analysed data from 726 women in the Midlife in the US study.

Participants were asked how much they worried about becoming less attractive with age, having more health issues and being too old to have children.

Blood samples were used to assess ageing with two epigenetic clocks: DunedinPACE, which estimates the pace of biological ageing, and GrimAge2, which estimates cumulative biological damage.

The study was conducted by researchers at NYU School of Global Public Health.

Worrying about declining health showed the strongest links with epigenetic ageing, while anxiety about attractiveness and fertility was not significantly associated with biological markers.

The authors suggest health worries are more common and persist over time, whereas concerns about appearance and reproduction may fade with age.

“Women in midlife may also be multiple in roles, including caring for their ageing parents,” Rodrigues said.

“As they see older family members grow older and become sick, they may worry about whether the same thing will happen to them.”

The authors caution that the study offers a snapshot in time and other factors may influence these biological changes.

When analyses were adjusted for health behaviours such as smoking and alcohol use, the link between ageing anxiety and epigenetic ageing decreased and was no longer significant.

“Our research identifies ageing anxiety as a measurable and modifiable psychological determinant that seems to be shaping ageing biology,” said Adolfo Cuevas, associate professor of social and behavioural sciences and the study’s senior author.

They call for more research to clarify how this anxiety influences ageing over time, to guide support for those experiencing ageing anxiety.

“Ageing is a universal experience.” Rodrigues said.

“We need to start a discourse about how we as a society, through our norms, structural factors and interpersonal relationships, address the challenges of ageing.”

Continue Reading

Insight

WUKA and Royal Yachting Association partner to support women and girls in sailing

Published

on

WUKA has announced a groundbreaking partnership with the Royal Yachting Association (RYA), including RYA Scotland and RYA Northern Ireland, supporting women and girls in sailing.

Building on WUKA’s growing #TackleAnything campaign – which has already reached thousands of girls across sports in the UK – this collaboration brings practical period solutions into sailing.

Together, WUKA and the RYA are committed to breaking down barriers so periods never limit confidence, participation, or performance on the water.

Ruby Raut, WUKA founder & CEO, said: “Partnering with the RYA has been incredibly important for us at WUKA.

“Sailing is an amazing way for women and girls to build confidence, and periods shouldn’t hold anyone back from enjoying the water or reaching their full potential.

“Through this partnership and our #TackleAnything campaign, we’re proud to provide practical solutions and innovative products that help female sailors feel comfortable, confident, and free to focus on learning, performing, and having fun.

“Breaking down barriers and supporting women to tackle anything — on land, at sea, and everywhere in between – has never felt more meaningful.”

WUKA, which stands for Wake-Up Kick Ass, shares the RYA’s commitment to inclusivity and empowerment.

In 2023, WUKA launched #TackleAnything, a campaign supporting women, girls and sportspeople with periods. Since its launch, the initiative has reached 3,576 girls across 46 clubs and partnered with a range of sports across the UK – from Scottish Gymnastics to Titans wheelchair basketball – helping young athletes play without limits and stay confident, comfortable, and in the game.

The brand offers period-friendly aquatic apparel and practical solutions that help women train and compete with freedom of movement and total assurance.

Through this partnership, WUKA will provide innovative period swimwear for young sailors across key RYA programmes, including the NI Sailing Team, the RYA Scotland Performance Pathway Programme, and the British Sailing Pathways Talent Academies.

By combining WUKA’s mission to challenge stigma with the RYA’s commitment to inclusion, the partnership ensures young sailors can focus on what matters most – learning, performing, and enjoying their time on the water – with confidence and comfort. RYA members will also receive a 10 per cent discount on WUKA products.

Sailing offers incredible benefits for women and girls, but time on the water can present unique challenges -particularly during menstruation.

Together, WUKA and the RYA are providing practical solutions that remove these barriers, helping young sailors participate fully and confidently in the sport.

Sara Sutcliffe, RYA CEO, said: “At the RYA, we have been making strides to break down barriers for women of all ages to help ensure they can experience the water in a supportive and positive environment.

“From education workshops and practical sessions, we want to make sure our female sailors are empowered and this partnership is another great example of how we can demonstrate possible tools to equip them to succeed”.

This partnership is part of the RYA’s wider commitment to making sailing a sport where women and girls can thrive. Alongside initiatives such as the Female Futures Group, the Women’s Race Officials Programme and all new Talent Academy Female Future’s Camps; it demonstrates a continued focus on removing barriers and creating meaningful opportunities across every stage of the sailing.

WUKA’s involvement ensures that practical solutions are available on the water, from innovative period swimwear to support resources, helping young sailors feel fully equipped and confident during training and competition.

By integrating these tools into RYA programmes, WUKA brings a new level of comfort and assurance to female athletes, allowing them to focus entirely on performance, enjoyment, and growth in the sport.

For any women and girls looking to learn more about sailing, visit www.rya.org.uk.

For more information on WUKA visit www.wuka.co.uk.

Continue Reading

Insight

Study links changing population to low London screening rates

Published

on

London’s shifting population is holding down breast screening uptake, experts have said, with the capital at 62.8 per cent in 2024, below the NHS’s acceptable 70 per cent threshold.

The London Assembly Health Committee recently heard that the capital faces distinct challenges compared with the rest of the country and that these issues must be addressed.

Josephine Ruwende, a cancer screening lead at NHS England, said frequent moves within the rented sector and the cost-of-living crisis pushing people out of London had made it difficult to reach eligible patients, which she described as “population churn”.

She said: “This is people changing addresses and then not updating their GP, this then affects the invitation process because GP details are used to identify individuals who are eligible.

“In boroughs where we have the highest population churn, we see it strongly associated with lower uptake.”

She noted that even in the wealthiest boroughs there can be high levels of movement, with around 40 per cent of residents changing address within a year.

Such areas also tend to have more people who own second homes or spend long periods abroad, making it harder for the NHS to keep contact details up to date.

As a result, screening invitations may be sent to out-of-date addresses or to people who are overseas.

Leeane Graham, advocacy lead at Black Women Rising, which supports women of colour with a cancer diagnosis, said there were cultural barriers, fear and a mistrust of the health service due to previous experience within communities.

She said: “If you’ve never been for a breast screening before, the thought of having a mammogram can be really, really terrifying.”

Helen Dickens, from Breast Cancer Now, said other reasons included a lack of understanding of breast screening, along with concerns about discomfort, trust and practical issues such as travel.

She said: “We have amazing public transport and we feel that we’ve got great accessibility, but we also know that we don’t have screening centres in every borough.

“We know that for some women that barrier of transport and access will still be a really big reason why they’re not attending screenings.”

NHS London launched its first screening campaign last year in response to the figures, aiming to increase detection at an earlier stage.

Continue Reading

Trending

Copyright © 2025 Aspect Health Media Ltd. All Rights Reserved.