Patient-Reported Outcomes in Implant-Based Breast Reconstruction Alone or in Combination with a Titanium-Coated Polypropylene Mesh – A Detailed Analysis of the BREAST-Q and Overview of the Literature

• Published in: Geburtshilfe und Frauenheilkunde Vol. 75; no. 7; pp. 692 - 701
• Main Authors: Dieterich, M., Angres, J., Stubert, J., Stachs, A., Reimer, T., Gerber, B.
• Format: Journal Article
• Language: English; German
• Published: Stuttgart · New York Georg Thieme Verlag KG 01.07.2015
• Subjects: Original Article; Lebensqualität; BREAST-Q; breast reconstruction; patient-reported outcome; Netz; Patientenzufriedenheit; quality of life; TiLOOP® Bra; mesh; Brustrekonstruktion
• ISSN: 0016-5751; 1438-8804
• DOI: 10.1055/s-0035-1546218

Abstract Background: Complication rates and surgical outcomes are well reported for implant-based breast reconstruction (IBBR) using supportive materials for the inferior pole of the breast. Patient-reported outcomes (PRO) are underrepresented. The aim of this study was to compare PRO in IBBR using implants alone or in combination with a synthetic mesh. Methods and Methods: PRO was measured in patients undergoing IBBR alone or in combination with a titanium-covered polypropylene mesh (TiLOOP® Bra). In this non-randomized observational trial PRO was retrospectively assessed using the validated self-reporting BREAST-Q. The raw responses of all questions applied in each domain and transformed BREAST-Q data using the Q-Score are presented. Results: Of 90 eligible women, 42 received IBBR alone and 48 received IBBR in combination with mesh. No differences in complication rates were observed. The return rate was 67.7 % and was comparable between the groups (p = 0.117). PRO revealed no differences regarding satisfaction with breast shape (p = 0.079), outcome (p = 0.604), nipple sensitivity (p = 0.502), preoperative information (p = 0.195), office staff (p = 0.462), psychosocial well-being (p = 0.370), sexual well-being (p = 0.508) and physical well-being (p = 0.654). Significant differences were noted regarding satisfaction with the surgeon (p = 0.013) and medical staff (p = 0.035) as well as the response behavior of certain questions of the sub-domains, thus helping to further stratify PRO with regards to aesthetic outcome. However, no differences were observed in the main BREAST-Q results. Conclusion: Use of the TiLOOP® Bra in IBBR results in comparable BREAST-Q scores compared with IBBR alone. Evaluating the BREAST-Q sub-domains helps to stratify PRO more profoundly and assists in interpreting the overall results and specific research questions.