Long-term patient-reported outcomes following postmastectomy breast reconstruction: An 8-year examination of 3268 patients Journal Article

Authors: Nelson, J. A.; Allen, R. J. Jr; Polanco, T.; Shamsunder, M.; Patel, A. R.; McCarthy, C. M.; Matros, E.; Dayan, J. H.; Disa, J. J.; Cordeiro, P. G.; Mehrara, B. J.; Pusic, A. L.
Article Title: Long-term patient-reported outcomes following postmastectomy breast reconstruction: An 8-year examination of 3268 patients
Abstract: Objective:To better understand the long-Term patient-reported outcomes (PROs) in satisfaction and health-related quality of life (QOL) following post-mastectomy reconstruction (PMR) using the BREAST-Q, comparing PROs from patients undergoing implant-based breast reconstruction (IBR) or autologous breast reconstruction (ABR).Summary of Background Data:Multiple studies have demonstrated growth in mastectomy rates and concurrent increase in PMR utilization. However, most studies examining PMR PROs focus on short postoperative time periods-mainly within 2 years.Methods:BREAST-Q scores from IBR or ABR patients at a tertiary center were prospectively collected from 2009 to 2017. Mean scores and standard deviations (SDs) were calculated for satisfaction with breast, satisfaction with outcome, psychosocial well-being, physical well-being of the chest, and sexual well-being. Satisfaction with breasts and physical well-being of the chest were compared using regression models at postoperative years 1, 3, 5, and 7.Results:Overall, 3268 patients were included, with 336 undergoing ABR and 2932 undergoing IBR. Regression analysis demonstrated that ABR patients had greater postoperative satisfaction with breast scores at all timepoints compared with IBR patients. Postoperative radiation and mental illness adversely impacted satisfaction with breast scores. Furthermore, mental illness impacted physical wellbeing of the chest at all timepoints. IBR patients had satisfaction scores that remained stable over the study period.Conclusion:This study presents the largest prospective examination of PROs in PMR to date. Patients who opted for ABR had significantly higher satisfaction with their breast and QOL at each assessed time point, but IBR patients had stable long-Term satisfaction and QOL postoperatively. © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: evidence-based medicine; breast cancer; breast reconstruction with autogenous tissue; breast reconstruction with prosthetic devices-1 stage; breast reconstruction with prosthetic devices-2 stage; breast-q module; patient satisfaction and breast reconstruction; patient-reported outcomes measures
Journal Title: Annals of Surgery
Volume: 270
Issue: 3
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Date Published: 2019-09-01
Start Page: 473
End Page: 483
Language: English
DOI: 10.1097/sla.0000000000003467
PUBMED: 31356276
PROVIDER: scopus
Notes: Article -- Export Date: 4 September 2019 -- Source: Scopus
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MSK Authors
  1. Joseph Disa
    204 Disa
  2. Babak Mehrara
    265 Mehrara
  3. Peter G Cordeiro
    245 Cordeiro
  4. Evan Matros
    80 Matros
  5. Joseph Henry Dayan
    19 Dayan
  6. Jonas Allan Nelson
    15 Nelson
  7. Aadit R Patel
    1 Patel