Direct-to-Implant Breast Reconstruction After Unilateral and Bilateral Mastectomy: Cross-Sectional Study of Patient Satisfaction and Quality of Life with BREAST-Q

• Published in: Aesthetic plastic surgery Vol. 47; no. 1; pp. 43 - 49
• Main Authors: Cogliandro, Annalisa, Salzillo, Rosa, Barone, Mauro, Tenna, Stefania, Cagli, Barbara, Persichetti, Paolo
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.02.2023; Springer Nature B.V
• Subjects: Breast cancer; Breast Implants; Breast Neoplasms - surgery; Cohort Studies; Cross-Sectional Studies; Female; Humans; Mammaplasty - methods; Mastectomy; Mastectomy - methods; Medicine; Medicine & Public Health; Original Article; Otorhinolaryngology; Patient Satisfaction; Plastic Surgery; Quality of Life; Retrospective Studies; Transplants & implants; Treatment Outcome; Mastectomy; Plastic surgery; Breast-q; Breast reconstruction; PROMs
• ISSN: 0364-216X; 1432-5241
• DOI: 10.1007/s00266-022-02986-5

Introduction Immediate single stage breast reconstruction is a challenging procedure with the goal of improving the quality of life of patients with breast cancer. The aim of this study is to evaluate using the BREAST-Q patient satisfaction, body perception and quality of life after direct-to-implant breast reconstruction comparing unilateral and bilateral reconstructions. Methods In this study we enrolled 56 women who underwent mastectomy and immediate single-stage direct-to-implant (DTI) breast reconstruction at Campus Bio-Medico University of Rome between 2013 and 2020. One year after surgery they were administered electronically the BREAST-Q post-operative module. Results Our two cohorts of patients consisted in 34 women who received unilateral nipple-sparing mastectomy and DTI breast reconstruction and 22 women who underwent bilateral nipple-sparing mastectomy and DTI breast reconstruction. Twenty-four of the 34 patients belonging to the unilateral group responded to the questionnaire (70.5%), while in the bilateral group responders were 16 out of 22 (72.7%). The BREAST-Q scores were compared between the two groups: patients undergoing bilateral mastectomy and breast reconstruction showed higher scores in every BREAST-Q domain compared to patients undergoing unilateral mastectomy and breast reconstruction with a statistically significant difference in the Satisfaction with breast ( P = 0.01), Sexual well-being ( P = 0.03), and Satisfaction with implants ( P = 0.01) domains. Conclusions Patients undergoing bilateral DTI breast reconstruction have a favorable postoperative surgical cosmetic outcome with a better patient’s body image perception and a higher post-operative level of satisfaction compared to unilateral DTI reconstruction after nipple-sparing mastectomy. Level of evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266