The role of music therapy for an individual client having undergone bilateral prophylactic mastectomy and breast reconstruction surgery : a single case study

Abstract

A mixed method case study was conducted to ascertain whether music therapy could play a role in addressing the body image, interpersonal and intrapersonal connectedness of a woman who has undergone a bilateral prophylactic mastectomy and breast reconstruction. Quantitative data were used to enrich and inform qualitative data. The participant was diagnosed with the mutated BRCA2 gene, which increases her risk to develop breast cancer by up to 80%. It also increases her risk to develop ovarian cancer by up to 30%. The participant attended six music therapy sessions over three weeks. Data were collected in three ways: video recordings of the sessions; completion of a qualitative music therapy questionnaire after the six sessions (the intervention), as well as the completion of Breast-Q© at the first session and a week after the final session. This produced four data sets. Qualitative data source A was composed of a thick description of excerpts of the video footage. The answers of the qualitative music therapy questionnaire comprised qualitative data source B. Both these qualitative data sources were thematically analysed by doing open coding, resulting in the development of first order codes, higher order codes, sub-themes and main themes. The two quantitative data sets, A1 and A2 were the pre-intervention and post-intervention quantitative Breast-Q© questionnaires. The questionnaires were converted to data by the Q-Score program and the data was interpreted according to the Breast-Q© user manual to produce the findings. The qualitative thematic analysis yielded rich results, describing the struggles of a woman who has undergone a bilateral prophylactic mastectomy and breast reconstruction. The quantitative data did not show statistically significant differences in the pre-, and postintervention scores. The study period was too short to address emotional discomfort and concerns brought to the fore by the music therapy adequately. The sample size was also small, as only one woman was recruited from a few suitable candidates, due to the low incidence of the diagnosis of BRCA1/2 mutated genes and the small number of women opting for risk reduction surgery. Further research could include BRCA1/2 positive women who had breast cancer, and who have undergone a prophylactic mastectomy of the healthy breast. This could significantly increase the number of candidates for a larger study.