Satisfaction with breasts following autologous reconstruction: Assessing associated factors and the impact of revisions Journal Article
| Authors: | Kim, M.; Vingan, P.; Boe, L. A.; Mehrara, B. J.; Stern, C. S.; Allen, R. J. Jr; Nelson, J. A. |
| Article Title: | Satisfaction with breasts following autologous reconstruction: Assessing associated factors and the impact of revisions |
| Abstract: | Background: Autologous breast reconstruction (ABR) may confer higher patient-reported outcomes than implant breast reconstruction, but an in-depth examination of factors associated with satisfaction after ABR is lacking. The authors aimed to determine independent predictors of 1-year satisfaction with breasts after ABR and assess the importance of elective procedures on satisfaction. Methods: A retrospective analysis of patients who underwent abdominally based ABR between 2010 and 2021 and completed the BREAST-Q Satisfaction with Breasts module at 1 year was performed. Elective procedures consisted of breast revision and nipple-areola complex reconstruction. Results: A total of 959 patients were included. Satisfaction with Breasts score improved from 53 (interquartile range [IQR], 44 to 64) preoperatively to 64 (IQR, 53 to 78) at 1 year postoperatively (P < 0.001). Factors significantly associated with decreased postoperative score included lower preoperative scores (β = 0.19 [95% CI, 0.08 to 0.31]; P = 0.001), older age (β = -0.17 [95% CI, -0.34 to -0.01]; P = 0.042), Asian race (versus White, β = -6.7 [95% CI, -12 to -1.7]; P = 0.008), and a history of psychiatric diagnoses (β = -3.4 [95% CI, -6.2 to -0.66]; P = 0.015). Patients who received radiation therapy (β = -5.6 [95% CI, -9.0 to -2.3]; P = 0.001) or had mastectomy skin flap/nipple necrosis (β = -3.8 [95% CI, -7.6 to -0.06]; P = 0.046) also had significantly decreased scores. Satisfaction with Breasts scores improved significantly after breast revision procedures (from 54 [IQR, 42 to 65] to 65 [IQR, 54 to 78]; P < 0.001), and nipple-areola complex reconstruction (from 58 [IQR, 47 to 71] to 67 [IQR, 57 to 82]; P < 0.001). Conclusions: Multiple independent patient and treatment level factors are associated with lower 1-year Satisfaction with Breasts scores following ABR. Elective procedures have the potential to improve satisfaction. Understanding these findings is imperative for optimizing clinical decision-making and managing expectations. Copyright © 2024 American Society of Plastic Surgeons. |
| Keywords: | adult; middle aged; patient satisfaction; retrospective studies; mastectomy; psychology; breast neoplasms; breast reconstruction; mammaplasty; retrospective study; breast tumor; reoperation; surgery; patient reported outcome measures; transplantation, autologous; autotransplantation; patient-reported outcome; procedures; humans; human; female |
| Journal Title: | Plastic and Reconstructive Surgery |
| Volume: | 155 |
| Issue: | 2 |
| ISSN: | 0032-1052 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2025-02-01 |
| Start Page: | 235 |
| End Page: | 244 |
| Language: | English |
| DOI: | 10.1097/prs.0000000000011571 |
| PUBMED: | 38857436 |
| PROVIDER: | scopus |
| PMCID: | PMC11628637 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding MSK author is Jonas A. Nelson -- Source: Scopus |
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