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 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 5 September 2017 -- Source: Scopus |
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