University Honors

Breast cancer survivors often experience significant psychosocial burden after treatment, including depression and anxiety. Although post-mastectomy breast reconstruction (PMBR) has been associated with improved body image and quality of life, existing literature on psychiatric outcomes after reconstruction remains mixed, with some studies reporting psychosocial benefits while others finding no significant differences. Additionally, much of the current literature focuses on patient-reported psychosocial well-being rather than incident psychiatric diagnoses reported in large clinical datasets. Using the TriNetX Collaborative Network, this study evaluated incident depression and generalized anxiety disorder (GAD) among women undergoing PMBR within five years of surgery, with marital status serving as the primary factor of interest. Multivariable Cox regression and propensity score-matched subgroup analyses were performed to evaluate predictors of psychiatric outcomes and compare PMBR patients with mastectomy patients without reconstruction. Married PMBR patients demonstrated significantly lower risk of depression and GAD compared with divorced and never-married patients, while divorced patients exhibited the highest relative psychiatric risk across analyses. Age and race/ethnicity were also associated with psychiatric outcomes. In direct matched comparisons, PMBR did not significantly differ from mastectomy with respect to depression or GAD risk, suggesting that reconstruction itself may not independently reduce psychiatric burden. Overall, these findings suggest that psychiatric outcomes following breast cancer surgery are more strongly influenced by social and demographic context, particularly marital status, than by reconstruction alone. These results highlight the importance of psychosocial screening and targeted mental health support for higher-risk patient populations following breast cancer treatment.