Patient-reported outcomes 1 year after immediate breast reconstruction: Results of the Mastectomy Reconstruction Outcomes Consortium study Journal Article

Authors: Pusic, A. L.; Matros, E.; Fine, N.; Buchel, E.; Gordillo, G. M.; Hamill, J. B.; Kim, H. M.; Qi, J.; Albornoz, C.; Klassen, A. F.; Wilkins, E. G.
Article Title: Patient-reported outcomes 1 year after immediate breast reconstruction: Results of the Mastectomy Reconstruction Outcomes Consortium study
Abstract: Purpose: The goals of immediate postmastectomy breast reconstruction are to minimize deformity and optimize quality of life as perceived by patients. We prospectively evaluated patient-reported outcomes (PROs) in women undergoing immediate implant-based or autologous reconstruction. Methods: Women undergoing immediate postmastectomy reconstruction for invasive cancer and/or carcinoma in situ were enrolled at 11 sites. Women underwent implant-based or autologous tissue reconstruction. Patients completed the BREAST-Q, a condition-specific PRO measure for breast surgery patients, and Patient-Reported Outcomes Measurement Information System–29, a generic PRO measure, before and 1 year after surgery. Mean changes in PRO scores were summarized. Mixed-effects regression models were used to compare PRO scores across procedure types. Results: In total, 1,632 patients (n = 1,139 implant, n = 493 autologous) were included; 1,183 (72.5%) responded to 1-year questionnaires. After analysis was controlled for baseline values, patients who underwent autologous reconstruction had greater satisfaction with their breasts than those who underwent implant-based reconstruction (difference, 6.3; P, .001), greater sexual well-being (difference, 4.5; P = .003), and greater psychosocial well-being (difference, 3.7; P = .02) at 1 year. Patients in the autologous reconstruction group had improved satisfaction with breasts (difference, 8.0; P = .002) and psychosocial well-being (difference, 4.6; P = .047) compared with preoperative baseline. Physical well-being of the chest was not fully restored in either the implant group (difference, 23.8; P = .001) or autologous group (22.2; P = .04), nor was physical well-being of the abdomen in patients who underwent autologous reconstruction (213.4; P, .001). Anxiety and depression were mitigated at 1 year in both groups. Compared with their baseline reports, patients who underwent implant reconstruction had decreased fatigue (difference, 21.4; P = .035), whereas patients who underwent autologous reconstruction had increased pain interference (difference, 2.0; P = .006). Conclusion: At 1 year after mastectomy, patients who underwent autologous reconstruction were more satisfied with their breasts and had greater psychosocial and sexual well-being than those who underwent implant reconstruction. Although satisfaction with breasts was equal to or greater than baseline levels, physical well-being was not fully restored. This information can help patients better understand expected outcomes and may guide innovations to improve outcomes. © 2017 by American Society of Clinical Oncology.
Journal Title: Journal of Clinical Oncology
Volume: 35
Issue: 22
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2017-08-01
Start Page: 2499
End Page: 2506
Language: English
DOI: 10.1200/jco.2016.69.9561
PROVIDER: scopus
PMCID: PMC5536162
PUBMED: 28346808
Notes: Article -- Export Date: 5 September 2017 -- Source: Scopus
Citation Impact
MSK Authors
  1. Andrea Pusic
    299 Pusic
  2. Evan Matros
    145 Matros