The impact of obesity on patient-reported outcomes following autologous breast reconstruction Journal Article


Authors: Nelson, J. A.; Sobti, N.; Patel, A.; Matros, E.; McCarthy, C. M.; Dayan, J. H.; Disa, J. J.; Cordeiro, P. G.; Mehrara, B. J.; Pusic, A. L.; Allen, R. J. Jr
Article Title: The impact of obesity on patient-reported outcomes following autologous breast reconstruction
Abstract: Background: Obesity is a significant public health concern and clear risk factor for complications following breast reconstruction. To date, few have assessed patient-reported outcomes (PROs) focused on this key determinant. Objective: Our study aimed to investigate the impact of obesity (body mass index ≥ 30) on postoperative satisfaction and physical function utilizing the BREAST-Q in a cohort of autologous breast reconstruction patients. Methods: An Institutional Review Board-approved prospective investigation was conducted to evaluate PROs in patients undergoing autologous breast reconstruction from 2009 to 2017 at a tertiary academic medical center. The BREAST-Q reconstruction module was used to assess outcomes between cohorts preoperatively and at 6 months, 1 year, 2 years, and 3 years after reconstruction. Results: Overall, 404 patients underwent autologous breast reconstruction with abdominal free-tissue transfer (244 non-obese, 160 obese) and completed the BREAST-Q. Although obese patients demonstrated lower satisfaction with breasts preoperatively (p = 0.04), no significant differences were noted postoperatively (p = 0.58). However, physical well-being of the abdomen was lower in the obese cohort compared with their non-obese counterparts at long-term follow-up (3 years; p = 0.04). Conclusion: Obesity significantly impacts autologous breast reconstruction patients. Although obese patients are more likely to present with dissatisfaction with breasts preoperatively, they exhibit comparable PROs overall compared with their non-obese counterparts, despite increased complications. © 2019, Society of Surgical Oncology.
Keywords: adult; cancer chemotherapy; controlled study; middle aged; patient satisfaction; major clinical study; postoperative period; outcome assessment; follow up; antineoplastic agent; prospective study; breast cancer; obesity; breast reconstruction; graft necrosis; body mass; graft failure; abdomen; adjuvant chemotherapy; surgical infection; clinical decision making; cross-sectional study; deep inferior epigastric perforator flap; free tissue graft; transverse rectus abdominis musculocutaneous flap; hematoma; seroma; superficial inferior epigastric artery flap; wound healing impairment; wound dehiscence; abdominal wall hernia; fat necrosis; preoperative radiotherapy; patient-reported outcome; human; female; article; physical well-being; obese patient
Journal Title: Annals of Surgical Oncology
Volume: 27
Issue: 6
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2020-06-01
Start Page: 1877
End Page: 1888
Language: English
DOI: 10.1245/s10434-019-08073-5
PUBMED: 31811437
PROVIDER: scopus
PMCID: PMC8435214
DOI/URL:
Notes: Article -- Source: Scopus
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MSK Authors
  1. Joseph Disa
    262 Disa
  2. Babak Mehrara
    448 Mehrara
  3. Peter G Cordeiro
    282 Cordeiro
  4. Evan Matros
    202 Matros
  5. Colleen Marie McCarthy
    143 McCarthy
  6. Joseph Henry Dayan
    100 Dayan
  7. Jonas Allan Nelson
    209 Nelson
  8. Nikhil Sobti
    6 Sobti
  9. Aadit R Patel
    7 Patel