Implant breast reconstruction and radiation: A multicenter analysis of long-term health-related quality of life and satisfaction Journal Article

Authors: Albornoz, C. R.; Matros, E.; McCarthy, C. M.; Klassen, A.; Cano, S. J.; Alderman, A. K.; Vanlaeken, N.; Lennox, P.; MacAdam, S. A.; Disa, J. J.; Mehrara, B. J.; Cordeiro, P. G.; Pusic, A. L.
Article Title: Implant breast reconstruction and radiation: A multicenter analysis of long-term health-related quality of life and satisfaction
Abstract: Background: Indications for radiotherapy in breast cancer treatment are expanding. Long-term satisfaction and health-related quality of life (HR-QOL), important outcomes after alloplastic breast reconstruction and radiation, have not been measured in irradiated patients by using a condition-specific, validated patient-reported outcomes instrument. The aim was to evaluate patient satisfaction and HR-QOL in patients with implant breast reconstruction and radiotherapy. Methods: A multicenter cross-sectional survey of patients who underwent implant-based breast reconstruction from three centers in the United States and Canada, with and without radiation, was performed. Satisfaction with breasts, satisfaction with outcome, psychosocial well-being, sexual well-being, and physical well-being outcomes were evaluated using the BREAST-Q © (Reconstruction Module). Multivariable analysis was performed to evaluate the effect of radiotherapy on patient satisfaction with breasts with adjustment by patient and treatment characteristics. Results: The response rate was 71 %, with 633 completed questionnaires returned. Mean follow-up was 3.3 years for irradiated patients (n = 219) and 3.7 years for nonirradiated patients (n = 414). Patients with radiation had significantly lower satisfaction with breasts (58.3 vs. 64.0; p < 0.01), satisfaction with outcome (66.8 vs. 71.4; p < 0.01), psychosocial well-being (66.7 vs. 70.9; p < 0.01), sexual well-being (47.0 vs. 52.3; p < 0.01), and physical well-being (71.8 vs. 75.1; p < 0.01) compared with nonirradiated patients. Multivariable analysis confirmed the negative effect of radiotherapy on satisfaction with breasts (β = -2.6; p = 0.03) when adjusted for patient and treatment factors. Conclusions: Radiotherapy has a negative effect on HR-QOL and satisfaction with breasts in patients with implant reconstruction compared with nonirradiated patients. The information provided here can inform decision-making and help set appropriate expectations for patients undergoing implant breast reconstruction and radiation. © 2014 Society of Surgical Oncology.
Keywords: adult; patient satisfaction; cancer surgery; major clinical study; united states; cancer radiotherapy; follow up; medical decision making; quality of life; breast cancer; breast reconstruction; questionnaire; cross-sectional study; psychological well being; canada; wellbeing; clinical assessment tool; breast implant; human; article; physical well being; sexual well being
Journal Title: Annals of Surgical Oncology
Volume: 21
Issue: 7
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2014-07-01
Start Page: 2159
End Page: 2164
Language: English
DOI: 10.1245/s10434-014-3483-2
PROVIDER: scopus
PUBMED: 24740825
Notes: Ann. Surg. Oncol. -- Cited By (since 1996):1 -- Export Date: 8 July 2014 -- CODEN: ASONF -- Source: Scopus
Citation Impact
MSK Authors
  1. Joseph Disa
    248 Disa
  2. Andrea Pusic
    299 Pusic
  3. Babak Mehrara
    385 Mehrara
  4. Peter G Cordeiro
    271 Cordeiro
  5. Evan Matros
    161 Matros
  6. Colleen Marie McCarthy
    130 McCarthy