Quality of life and patient satisfaction after microsurgical abdominal flap versus staged expander/implant breast reconstruction: a critical study of unilateral immediate breast reconstruction using patient-reported outcomes instrument BREAST-Q

• Published in: Breast cancer research and treatment Vol. 146; no. 1; pp. 117 - 126
• Main Authors: Liu, Chunjun, Zhuang, Yan, Momeni, Arash, Luan, Jie, Chung, Michael T., Wright, Eric, Lee, Gordon K.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01.07.2014; Springer; Springer Nature B.V
• Subjects: Activities of daily living; Adjuvant treatment; Adult; Analysis; Breast cancer; Breast Neoplasms - pathology; Breast Neoplasms - psychology; Breast Neoplasms - surgery; Breast Neoplasms - therapy; Cancer; Cancer research; Cancer therapies; Clinical outcomes; Clinical Trial; Cross-Sectional Studies; Databases, Factual; Female; Health aspects; Health Care Surveys; Humans; Mammaplasty - methods; Mastectomy; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Middle Aged; Neoplasm Staging; Oncology; Patient Satisfaction; Quality of Life; Risk Factors; Self Report; Surgery; Surgery, Plastic; Surgical Flaps; Surveys and Questionnaires; Treatment Outcome; Breast implant; Breast reconstruction; Free flap; Microsurgery; Plastic surgery; Tissue expander; Autologous breast reconstruction; Quality of life
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-014-2981-z

Staged expander–implant breast reconstruction (EIBR) and microsurgical abdominal flap breast reconstruction (MAFBR) are the most common modes of breast reconstruction (BR) in the United States. Whether the mode of breast reconstruction has an impact on patient quality of life (QoL) and satisfaction remains a question. A retrospective study was conducted identifying a population of 119 patients who underwent unilateral immediate BR. Only patients who were eligible for either EIBR or MAFBR based on preoperative characteristics were included in the study. The following parameters were retrieved: demographics, mode of reconstruction, cancer, recovery, QoL, and patient satisfaction. The latter two parameters were determined using the BREAST-Q BR module questionnaire. Two-way analysis of variance with mode of reconstruction and occurrence of complication as independent variables was used to determine the effect on patient satisfaction and QoL. The association between mode of reconstruction and patient response with each item of the QoL and satisfaction survey domains was analyzed. The overall response rate was 62.2 %. Non-respondents and respondents did not significantly differ in demographics, surgery type, cancer staging, adjuvant therapy, and complication rate. Age and BMI were significantly higher in MAFBR, while level of education was higher in EIBR. MAFBR had higher scores in psychosocial and sexual wellbeing, satisfaction with outcome, breast, information, and plastic surgeon when compared with patients who underwent EIBR. For patients eligible for both MAFBR and EIBR, MAFBR is associated with higher levels of satisfaction and QoL. Comprehensive pre-operative information of pros and cons of both modes of BR is crucial for patients to make a well-informed decision, thus, resulting in higher levels of satisfaction.