Abstract Introduction Immediate breast reconstruction (IBR) can be offered to breast cancer patients after mastectomy. A satisfactory breast symmetry has positive effects on psychosocial morbidity, quality of life and body image. The frequency of IBR were in 2017 in Region Örebro County 4%, lower than the national target on 20%. Aim The aim is to provide an overview of the work with IBR at Örebro University Hospital in 2016, regarding frequency of IBR, work with IBR at multidisciplinary team conferences, documentation of the patient’s opinion about IBR, delayed reconstructions, patient characteristics and presence of contraindications. Material and methods This was a retrospective study of all women who underwent mastectomy at Örebro University Hospital in 2016. Results Five of the 103 women got IBR with expander implants in connection to mastectomy, additionally 28 had no contraindications for IBR. Five of the women have discussed about IBR at multidisciplinary team conferences and seven had notes about their attitude to IBR. Ten women underwent delayed reconstruction during the follow-up, additional seven patients were waiting for surgery. There were no significant differences in patient characteristics between the groups “mastectomy and IBR” and “mastectomy only”. Conclusions The low frequencies of performed IBR, discussions at multidisciplinary team conferences and documentation of the patient’s opinion about IBR indicate that there is space for a more active work about IBR. Besides the women who got IBR, there were additionally 28 women without any contraindications for IBR, indicating that there is a considerable group that can become candidates for IBR.

Introdução: O câncer de mama é a neoplasia maligna mais prevalente em mulheres. Em decorrência do diagnóstico tardio, a mastectomia radical modificada (MRM) permanece como tratamento cirúrgico de escolha para a maioria das pacientes portadoras da doença. Em pacientes mastectomizadas, a reconstrução mamária com retalhos miocutâneos é a técnica que apresenta melhor resultado a longo prazo. Material e métodos: O estudo compara as taxas de recorrência local e sistêmica e a sobrevida livre de doença em pacientes submetidas à MRM, associada ou não à reconstrução mamária imediata com retalho miocutâneo transverso do reto abdominal (TRAM). Resultados: O grupo submetido à TRAM apresentou recorrência local de 11,8% e sistêmica de 35,7%, e o grupo da MRM, 4,4 e 26,1%, respectivamente. A sobrevida livre de doença (tempo decorrido entre a cirurgia e a primeira recorrência) foi, em média, de 105,4 meses (IC95% 97,0-113,72) no grupo MRM e de 95,4 meses (IC95% 80,7-110,0) no grupo TRAM, não havendo diferença estatisticamente significativa entre os grupos (P = 0,147). Conclusões: Em pacientes portadoras de câncer de mama, a reconstrução mamária imediata com retalho miocutâneo transverso do reto abdominal não influencia o prognóstico da doença, devendo ser oferecida às pacientes que não apresentam contraindicação clínica ao procedimento. / Introduction: Breast cancer is the most prevalent malignant neoplasia among women. In cases of late diagnoses, modified radical mastectomy (MRM) remains the surgical treatment of choice for most women with this disease, and breast reconstruction with myocutaneous flaps is the technique with the best long-term results. Material and methods: Local and systemic recurrence rates were compared, as well as diseasefree survival of patients who underwent MRM with or without immediate breast reconstruction using transverse rectus abdominis myocutaneous flap (TRAM). Results: The TRAM group had a local recurrence rate of 11.8% and a systemic recurrence rate of 35.7%; for the MRM group, these rates were 4.4 and 26.1%, respectively. Disease-free survival time (from surgery to first recurrence) was 95.4 months (95%CI 80.7-110.0) in the TRAM group and 105.4 (95%CI 97.0-113.72) in the MRM group, but the difference was not statistically significant (P = 0.147). In patients with breast cancer, immediate breast reconstruction with TRAM did not affect disease prognosis, and may be indicated to all patients who undergo MRM, except those with any clinical contraindications to the procedure.

Bakgrund: Bröstcancer är den vanligaste cancerformen bland kvinnor och i Sverige diagnostiseras cirka 7000 nya fall per år. Behandlingsstrategierna vid bröstcancer är i första hand kirurgi följd av eventuell strålbehandling och läkemedelsbehandling. Efter genomförd mastektomi erbjuds alla svenska kvinnor plastikkirurgisk rekonstruktion. Rekonstruktion är frivilligt men många kvinnor väljer att rekonstruera för att känna sig mer kvinnliga, mer självsäkra i sin kropp och sin sexualitet och som en “hel” människa igen. Det är framför allt yngre och ensamstående kvinnor som tycker det är viktigt med rekonstruktion. Syfte: I denna studie undersöktes livskvalitet hos mastektomerade kvinnor med eller utan efterföljande rekonstruktion, att jämföra uppfattning mellan grupperna och beroende på ålder, och hur de upplevde stödet från vården. Metod: Kvalitativ intervjustudie. 7 kvinnor intervjuades utifrån 8 öppna frågor rörande psykosocial situation relaterad till kroppsbild, sexualitet, beslutsfattande och stödbehov. Intervjuerna spelades in, transkriberades och analyserades med hjälp av innehållsanalys. Resultat: Innehållsanalysen delades in i 2 teman, livskvalitet och bröstcancerkirurgin, som delades in i 5 kategorier, psykisk hälsa, kroppsuppfattning, psykosocial hälsa, upplevelse av vården och valet: rekonstruktion/ej rekonstruktion. Oavsett om kvinnorna genomfört rekonstruktion eller inte så skattade de sin livskvalitet som god. De kvinnor som genomgått rekonstruktion skattade sin livskvalitet högre efter rekonstruktionen än innan. Beslutet om rekonstruktion togs utifrån personliga känslor och tankar. Kvinnorna som inte hade gjort rekonstruktion upplevde ingreppet som riskfyllt och onödigt. De kvinnor som genomförde rekonstruktionen ville inte känna sig stympade och efter operation upplevde att de kände sig mer kvinnliga och som en hel människa igen. Vården uppfattade kvinnorna som bra, men med ökat behov av eftervård och bättre kontinuitet. Slutsats: Oavsett om kvinnorna gjort rekonstruktion eller inte är de nöjda med sitt enskilda val och skattar sin livskvalitet god. Kvinnorna uppfattar bemötandet från vården bra men det finns ett behov av ökad kontakt efter behandlingsslut. / Background: Breast cancer is the most common cancer among women and in Sweden approximately 7000 new cases are diagnosed every year. The primary treatment for breast cancer is surgery with possible subsequent radiation therapy and chemotherapy. Following mastectomy all women in Sweden are offered a surgical breast reconstruction. This is an optional choice, but many women choose reconstruction in order to feel more feminine, more confident in their bodies and their sexuality, and as a more "whole" woman. It is mainly the younger and single women who chose to do a reconstruction. Purpose: This study examines the health related quality of life within women who did or did not undergo breast reconstruction, depending of choice, age and how they experienced the healthcare support. Method: Qualitative interview study with seven women who participated in the study. The interview contained eight open questions concerning psychosocial situation related to body image, sexuality, decision-making and support needs. The interviews were recorded, transcribed and analysed with Graneheim- and Lundmans content analysis. Results: The analysis from the transcript was categorized into 2 groups: Quality of life and the breastcancer surgery. These two groups were divided into psychic health, body image, psychosocial health, and experience of the health care and the choice of reconstruction. Both the women who chose to do the reconstruction and those who do not, rate their health related quality of life as high. The women who underwent reconstruction rated their quality of life higher after the reconstruction than before. The decision regarding reconstruction was based on personal thoughts, and women who did not do reconstruction wished to focus on wining their fight against cancer and that thought that breast reconstruction was a major surgery with a high risk of complications. Decision about reconstruction was based on feeling truncated without breasts and with the new breast they feel feminine and whole again. Conclusion: Whether the women have made a reconstruction or not they are satisfied with their individual choices and rate their quality of life as high. The women also have experienced the communication to health care staff as good, but they even experience a huge need for follow-ups. / Hälsorelaterad livskvalitet och psykosocial situation bland kvinnor från olika kulturer efter bröstcancerkirurgi med eller utan rekonstruktion.

Bakgrund: Bröstcancer är den främsta cancerformen hos kvinnor världen över. Kirurgi är den viktigaste behandlingen vid bröstcancer och innebär att antingen delar av bröstet eller hela bröstet avlägsnas. Till följd av kirurgin kan kvinnorna antingen välja att rekonstruera sitt bröst eller använda en protes. Många kvinnor beskriver en förändrad kroppsuppfattning efter bröstoperationerna. Syfte: Syftet med studien var att belysa kvinnors upplevelser av sin kroppsuppfattning och dess inverkan på vardagen efter bröstoperation till följd av bröstcancer. Metod: Tolv kvalitativa artiklar valdes ut, sammanställdes och analyserades enligt kvalitativ innehållsanalys. Sökningen av artiklarna genomfördes i CINAHL, PubMed och PsycINFO. Även manuell sökning genomfördes. Resultat: Att genomgå lumpektomi eller mastektomi visade sig ha en inverkan på kvinnornas identitet och feminitet. Det resulterade också i en upplevelse av asymmetri. Kvinnorna hade svårigheter att bemöta operationsområdet och sörjde sina tidigare kroppar. De copingstrategier som kvinnorna använde sig av för att hantera kroppsuppfattningen var anpassning av klädval, protesanvändning eller bröstrekonstruktion. Kroppsuppfattningen som kvinnorna erhöll efter operationen inverkade på deras sexualitet. Deras partner och andra sociala faktorer inverkade också på den kroppsuppfattning kvinnorna erhöll efter bröstoperationerna. Konklusion: Resultatet visar på att upplevelsen av kroppsuppfattningen efter bröstoperation är komplex. Det är därför viktigt att sjuksköterskan har ett personcentrerat förhållningssätt i bemötandet av den bröstopererade kvinnan. / Background: Breast cancer is the leading cancer among women worldwide. Surgery is the main treatment for breast cancer and leads to that part of the breast or the whole breast being removed. Following the surgery women can choose either to reconstruct their breast or use prosthesis. Many women describe an altered body image after the breast surgeries. Aim: The aim with the study was to illustrate women’s experience of their body image and its impact on everyday life after breast surgery due to breast cancer. Method: Twelve qualitative articles were included and were compiled and analyzed with qualitative content analysis. The article search was performed in CINAHL, PubMed and PsycINFO. Articles were also searched manually. Results: To undergo lumpectomy or mastectomy was found to have an impact on the identity and the femininity. It also resulted in an experience of asymmetry. The women had difficulties to face the surgical site and mourned their former bodies. The coping strategies that the women used to deal with their body image were to adapt their clothing choices, use prosthesis or undergo breast reconstruction. The body image the women received after the surgery had an impact on the women’s sexuality. Their partners and other social factors influenced the body image that the women received after the breast surgeries. Conclusion: The results show that the perception of body image after breast surgery is complex. That is why it is important that the nurse have an person-centered approach in the treatment of the breast operated woman.

Introdução: O câncer de mama é a neoplasia maligna mais prevalente em mulheres. Em decorrência do diagnóstico tardio, a mastectomia radical modificada (MRM) permanece como tratamento cirúrgico de escolha para a maioria das pacientes portadoras da doença. Em pacientes mastectomizadas, a reconstrução mamária com retalhos miocutâneos é a técnica que apresenta melhor resultado a longo prazo. Material e métodos: O estudo compara as taxas de recorrência local e sistêmica e a sobrevida livre de doença em pacientes submetidas à MRM, associada ou não à reconstrução mamária imediata com retalho miocutâneo transverso do reto abdominal (TRAM). Resultados: O grupo submetido à TRAM apresentou recorrência local de 11,8% e sistêmica de 35,7%, e o grupo da MRM, 4,4 e 26,1%, respectivamente. A sobrevida livre de doença (tempo decorrido entre a cirurgia e a primeira recorrência) foi, em média, de 105,4 meses (IC95% 97,0-113,72) no grupo MRM e de 95,4 meses (IC95% 80,7-110,0) no grupo TRAM, não havendo diferença estatisticamente significativa entre os grupos (P = 0,147). Conclusões: Em pacientes portadoras de câncer de mama, a reconstrução mamária imediata com retalho miocutâneo transverso do reto abdominal não influencia o prognóstico da doença, devendo ser oferecida às pacientes que não apresentam contraindicação clínica ao procedimento. / Introduction: Breast cancer is the most prevalent malignant neoplasia among women. In cases of late diagnoses, modified radical mastectomy (MRM) remains the surgical treatment of choice for most women with this disease, and breast reconstruction with myocutaneous flaps is the technique with the best long-term results. Material and methods: Local and systemic recurrence rates were compared, as well as diseasefree survival of patients who underwent MRM with or without immediate breast reconstruction using transverse rectus abdominis myocutaneous flap (TRAM). Results: The TRAM group had a local recurrence rate of 11.8% and a systemic recurrence rate of 35.7%; for the MRM group, these rates were 4.4 and 26.1%, respectively. Disease-free survival time (from surgery to first recurrence) was 95.4 months (95%CI 80.7-110.0) in the TRAM group and 105.4 (95%CI 97.0-113.72) in the MRM group, but the difference was not statistically significant (P = 0.147). In patients with breast cancer, immediate breast reconstruction with TRAM did not affect disease prognosis, and may be indicated to all patients who undergo MRM, except those with any clinical contraindications to the procedure.

Possibilities of Breast Cancer Patients in Connection with Plastic Reconstructive Surgery Oncological disease is one of the diseases basically no one is able to influence. It is not a disease anyone would want. It starts slowly, stealthily and is often overlooked. Yet, oncological disease always changes our whole past life, within family, workplace, and our leisure activities, both in physical and psychological terms. Any patient deals with this disease differently, also the approach to these patients has to be highly individualized. Every patient goes through all the phases of the disease at a different pace and with varying success and every patient copes with it in a different way and is then able to return to his or her old life. Oncological disease is one of the most serious diseases and I dare say that breast cancer is for women very traumatic, changing their position in all roles; intensity is usually placed on a woman?s psyche. Every woman needs an individual approach from a physician, non-physician and especially from her family. The disease does not affect only the patient, but also the whole family and her environment. This diploma thesis deals with the possibilities of breast cancer patients in connection with plastic reconstructive surgery. Four objectives were set... The first objective was to determine the level of patient awareness of the possibilities of reconstructing the missing breast. The research showed that patients lack information and the majority of respondents received complete information from a mammologist, or a surgeon when dealing with the primary breast cancer diagnosis. The second objective was to find out whether patients are interested in co-decisions on the method of breast reconstruction. Based on the research, we concluded that yes, they are interested in deciding on the method, but it is important for them to have enough information and to know the doctor?s opinion. The third objective was to see whether patients have the opportunity to co-decide on the method of breast reconstruction. The results showed that patients have the possibility to decide on the choice of method, but in dependence on the possibilities, which are for each patient individual. It is not possible to use and select from all methods for each patient, it is necessary to approach each respondent individually and with complete knowledge of the course of her disease. The fourth objective was to define the most frequent patients? questions in connection with breast reconstruction. The results of interviews showed that the most frequently asked questions related to the length and number of hospitalizations and return to the social, professional and personal life. The diploma thesis is divided into two parts?theoretical and empirical. The theoretical part describes the historical development of reconstructing the missing breast, primary cancer disease and its classification. A greater part includes the possibilities of reconstructing the missing breast and specific nursing care for these patients. To process the empirical part of this thesis, qualitative research was chosen. The method of questioning, using semi-structured interviews with open questions, was selected. The research sample consisted of 11 patients at the Department of Plastic Surgery, University Hospital in Pilsen and 1 client of Mama Help Center in Pilsen. Three research questions were formulated. 1. What are the obstacles to the lack of information about breast reconstruction? The research shows that the patients outside the big specialized mammological centers have less access to specialized information and the research shows generally apparent absence of written information for patients on this topic.

Introdução: O câncer de mama é a neoplasia maligna mais prevalente em mulheres. Em decorrência do diagnóstico tardio, a mastectomia radical modificada (MRM) permanece como tratamento cirúrgico de escolha para a maioria das pacientes portadoras da doença. Em pacientes mastectomizadas, a reconstrução mamária com retalhos miocutâneos é a técnica que apresenta melhor resultado a longo prazo. Material e métodos: O estudo compara as taxas de recorrência local e sistêmica e a sobrevida livre de doença em pacientes submetidas à MRM, associada ou não à reconstrução mamária imediata com retalho miocutâneo transverso do reto abdominal (TRAM). Resultados: O grupo submetido à TRAM apresentou recorrência local de 11,8% e sistêmica de 35,7%, e o grupo da MRM, 4,4 e 26,1%, respectivamente. A sobrevida livre de doença (tempo decorrido entre a cirurgia e a primeira recorrência) foi, em média, de 105,4 meses (IC95% 97,0-113,72) no grupo MRM e de 95,4 meses (IC95% 80,7-110,0) no grupo TRAM, não havendo diferença estatisticamente significativa entre os grupos (P = 0,147). Conclusões: Em pacientes portadoras de câncer de mama, a reconstrução mamária imediata com retalho miocutâneo transverso do reto abdominal não influencia o prognóstico da doença, devendo ser oferecida às pacientes que não apresentam contraindicação clínica ao procedimento. / Introduction: Breast cancer is the most prevalent malignant neoplasia among women. In cases of late diagnoses, modified radical mastectomy (MRM) remains the surgical treatment of choice for most women with this disease, and breast reconstruction with myocutaneous flaps is the technique with the best long-term results. Material and methods: Local and systemic recurrence rates were compared, as well as diseasefree survival of patients who underwent MRM with or without immediate breast reconstruction using transverse rectus abdominis myocutaneous flap (TRAM). Results: The TRAM group had a local recurrence rate of 11.8% and a systemic recurrence rate of 35.7%; for the MRM group, these rates were 4.4 and 26.1%, respectively. Disease-free survival time (from surgery to first recurrence) was 95.4 months (95%CI 80.7-110.0) in the TRAM group and 105.4 (95%CI 97.0-113.72) in the MRM group, but the difference was not statistically significant (P = 0.147). In patients with breast cancer, immediate breast reconstruction with TRAM did not affect disease prognosis, and may be indicated to all patients who undergo MRM, except those with any clinical contraindications to the procedure.

Bakgrund: Bröstcancer är den vanligaste cancerformen hos kvinnor. I vissa fall måste kvinnan ta bort delar av, hela eller båda brösten, en så kallad mastektomi. Förlora bröstet är både psykiskt och fysiskt svårt och livskvaliteten påverkas. Kvinnan kan välja att genomgå en bröstrekonstruktion. Syfte: Syftet var att belysa kvinnors erfarenheter i samband med bröstrekonstruktion efter mastektomi. Metod: En allmän litteraturstudie genomfördes med nio vetenskapliga artiklar med kvalitativ ansats och sammanställdes med innehållsanalys. Resultat: För att belysa kvinnornas erfarenheter presenteras resultatet genom tre teman: erfarenheter att få information och stöd, förändrad kroppsuppfattning, förväntningar och fysisk återhämtning och slutligen livskvalitet och att bli hel igen. I resultatet framkom det hur viktigt det var för kvinnorna att få en relation till kontaktsjuksköterskan. Med denna kontakt kunde kvinnan känna trygghet och ta till sig information och göra sina val utan oro. Behovet av stödgrupp för kvinnorna under återhämtningsprocessen framkom. Kvinnors kroppsuppfattning förändrades. Slutsats: En bröstrekonstruktion gav kvinnor deras livslust tillbaka och kunde se ljust på framtiden med en hel kropp. Det är därför av stor vikt att sjuksköterskan förstår kvinnorna och deras erfarenheter av hur det är att genomgå en bröstrekonstruktion så att de kan erbjuda stöd och ge omvårdnad under hela processen. / Background: Breast cancer is the most common cancer that affects women. In some cases, woman must remove parts of or both breasts, a so-called mastectomy. Losing breasts is both mentally and physically difficult and quality of life is affected and may choose to undergo breast reconstruction. Aim: The aim was to illustrate women's experiences in connection with breast reconstruction after mastectomy. Method: A general literature study was conducted with nine scientific articles with qualitative approach and analyzed with content analysis. Result: To illustrate women's experiences, result is presented through three themes: experiences of gaining information and support, changing body image, expectations and physical recovery, and quality of life and becoming whole again. Results showed the importance to have a contact nurse. With this contact, she felt secure and absorbed information and made choices without worry. The need for a support group for women during the recovery process emerged, body perception changed. Conclusion: Breast reconstruction gave their life back and felt whole again. It is therefore of great importance that nurse´s understand their experiences of how it feels to undergo a breast reconstruction so that they can offer support and provide care throughout the process.

Introduction: Breast cancer is the most common tumor disease in women in Sweden and approximately 9000 cases are reported each year. More advanced testing methods and diagnostics have led to a rise in mastectomies and later breast reconstruction among breast cancer patients. Understanding patient experience of these life-changing surgeries is vital for nursing and therefore also how nurses adapt their work to these experiences. Aim: The purpose of this study was to describe female patients’ experiences before and after undergoing a mastectomy and possible breast reconstruction. Method: Qualitative literature review. Data was collected through the databases PubMed and Cinahl. This study used ten articles that fulfilled the criteria and were assessed to be of medium or high quality according to a quality review from Forsberg & Wengström (2016). A content analysis was made to identify categories and subcategories in the studies. Result: Categories identified in the results were the following: the road to the procedure, the changed body, and adjustment to daily life. The subcategories identified were the following: need for information, support, and communication, the decision-making process, perception of the body, affected relationship with partner, sense of lost womanliness and femininity, and consequences of the procedure. Conclusion: The study’s results highlight that a woman who undergoes a mastectomy need of information and support. After undergoing a mastectomy, the woman may suffer from an altered body image and a limited social life. It can also cause other difficulties and complications. It is therefore important that nurses have insight into patient experiences to give the patients adequate care and support. / Introduktion: Bröstcancer är den vanligaste tumörsjukdomen hos kvinnor i Sverige och runt 8000 fall rapporteras årligen. Mer avancerade testnings- och diagnosmetoder har lett till en ökning i antalet mastektomier och en efterföljande bröstrekonstruktion hos denna patientgrupp. Att förstå patienternas upplevelser av ingreppet är av stor vikt för omvårdnaden och för sjuksköterskans arbete med dessa. Syfte: Syftet med denna studie var att beskriva kvinnliga patienters upplevelser före och efter att ha genomgått en mastektomi och eventuell bröstrekonstruktion. Metod: Kvalitativ litteraturöversikt. Data insamlades via databaserna Pubmed och Cinahl. Till studien användes tio artiklar som mötte studiens kriterier och bedömdes ha medelhög- eller hög kvalitet enligt kvalitetsgranskning från Forsberg & Wengström (2016). En innehållsanalys utfördes för att identifiera huvudkategorier och underkategorier i studierna. Resultat: Huvudkategorier som identifierades var vägen fram till ingreppet, den förändrade kroppen, och anpassning till vardagslivet. De underkategorier som identifierades var behov av information, stöd och kommunikation, beslutsfattandeprocessen, synen på kroppen, påverkan på relationen med partnern, förlorad kvinnlighet och konsekvenser av ingrepp. Slutsats: Studiens resultat belyser att kvinnor som genomgår en mastektomi är i stort behov av information och stöd. Efter att ha genomgått en mastektomi kan kvinnan drabbas av förändrad kroppsbild och begränsat socialt liv. Det kan även medföra andra svårigheter och komplikationer. Det är därför av stor vikt att sjuksköterskan har insikt om patienters upplevelser för att kunna tillgodose patienterna med god omvårdnad och stöd.

Introduktion: Idag är cancer världens näst vanligaste dödsorsak bland människor och i Sverige är bröstcancer den vanligaste cancerformen. En behandlingsmetod vid bröstcancer är mastektomi, avlägsnande av bröstvävnad. Att drabbas av cancer och förlora brösten i samband med behandlingen kan påverka kvinnans välbefinnande, och bröstrekonstruktion erbjuds då för att ge kvinnor nya bröst efter mastektomi. Syfte: Belysa kvinnors reflektioner och erfarenheter efter bröstrekonstruktion till följd av cancerbehandlande mastektomi Metod: En litteraturöversikt med deskriptiv design. Studien baseras på sökningar i databaserna PubMed och Cinahl. Elva vetenskapliga originalartiklar valdes ut med kvalitativ ansats och kvalitetsgranskades enligt SBU:s granskningsmall för kvalitativa studier. Resultat: Fem kategorier av reflektioner och erfarenheter identifierades; behov av rekonstruktion, återhämtning, information, kroppsuppfattning samt stöd. Kvinnorna upplevde fysiska, psykiska och känslomässiga svårigheter i samband med behandling, ingrepp och återhämtning. Kvinnornas behov av, tillgång till och mottaglighet av information påverkade upplevelsen av medverkan i sin vård och säkerhet i sitt val av behandling.  Kvinnorna upplevde utmaningar i sin kroppsuppfattning relaterat till normalitet och sexualitet. Stöd från närstående, utomstående och vårdpersonal gjorde skillnad i kvinnornas upplevda lidande efter ingreppet. Slutsats: Kvinnorna upplevde sin livssituation olika. Kvinnornas upplevelser skiljde sig i att acceptera sin nya kropp, behov av stöd samt somatiska problem. Resultatet visade att det finns ett behov av fortsatt forskning av svenska kvinnors upplevda livssituation efter bröstrekonstruktion. Nyckelord: Bröstcancer, bröstrekonstruktion, mastektomi, upplevelse / Background: Cancer is the world's second most common cause of death among humans and breast cancer is the most common form of cancer in Sweden. Mastectomy is a treatment method for breast cancer which involves the removal of breast tissue. To be diagnosed with cancer and to lose breasts during treatment can affect a woman’s wellbeing. Women are therefore usually offered breast reconstruction post­mastectomy. Aim: To highlight women’s reflections and experiences after postmastectomy breast reconstruction. Method: A literature review with descriptive design. The study was based on searches in the databases PubMed and Cinahl. Eleven scientific articles were chosen, and quality reviewed using SBU:s review template for qualitative studies. Result: Five categories of reflections and experiences emerged: need of reconstruction, recovery, information, body image and support. The women experienced physical, psychological and emotional difficulties during recovery. The women’s need for, access to and receptivity of information affected their experience of being involved in their care and certainty in their choices of treatment. The women experienced challenges of their experienced body image related to normality and sexuality. Support from close relatives, outsiders and healthcare professionals during recovery made a difference in the women’s perceived suffering after breast reconstruction surgery. Conclusion: The women experienced differing perceptions of their life situation. The women’s experiences differed in bodily acceptance, the need for support and somatic difficulties. Further research is needed on the perceived life situation of Swedish women. Keywords: Breast cancer, breast reconstruction, mastectomy, experience