Quality of life and patient-reported outcomes in breast cancer survivors: A multicenter comparison of four abdominally based autologous reconstruction methods Journal Article
| Authors: | Macadam, S. A.; Zhong, T.; Weichman, K.; Papsdorf, M.; Lennox, P. A.; Hazen, A.; Matros, E.; Disa, J.; Mehrara, B.; Pusic, A. L. |
| Article Title: | Quality of life and patient-reported outcomes in breast cancer survivors: A multicenter comparison of four abdominally based autologous reconstruction methods |
| Abstract: | Background: Approximately 20 percent of women select autologous tissue for postmastectomy breast reconstruction, and most commonly choose the abdomen as the donor site. An increasing proportion of women are seeking muscle-sparing procedures, but the benefit remains controversial. It is therefore important to determine whether better outcomes are associated with these techniques, thereby justifying longer operative times and increased costs. Methods: Patients from five North American centers were eligible if they underwent reconstruction by means of the deep inferior epigastric artery perforator (DIEP) flap, muscle-sparing free transverse abdominis myocutaneous (TRAM) flap, free TRAM flap, or the pedicled TRAM flap. Patients were sent the BREAST-Q. Demographics and complications were collected. Results: The authors analyzed 1790 charts representing 670 DIEP, 293 muscle-sparing free TRAM, 683 pedicled TRAM, and 144 free TRAM patients with an average follow-up of 5.5 years. Flap loss did not differ by flap type. Partial flap loss was higher in pedicled TRAM compared with DIEP (p = 0.002). Fat necrosis was higher in pedicled TRAM compared with DIEP and muscle-sparing free TRAM (p < 0.001). Hernia/bulge was highest in pedicled TRAM (p < 0.001). Physical well-being (abdomen) scores were higher in DIEP compared with pedicled TRAM controlling for confounders. Conclusions: Complications and patient-reported outcomes differ when comparing abdominally based breast reconstruction techniques. The results of this study show that the DIEP flap was associated with the highest abdominal well-being and the lowest abdominal morbidity compared with the pedicled TRAM flap, but did not differ from muscle-sparing free TRAM and free TRAM flaps. Copyright © 2015 by the American Society of Plastic Surgeons. |
| Journal Title: | Plastic and Reconstructive Surgery |
| Volume: | 137 |
| Issue: | 3 |
| ISSN: | 0032-1052 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2016-03-01 |
| Start Page: | 758 |
| End Page: | 771 |
| Language: | English |
| DOI: | 10.1097/01.prs.0000479932.11170.8f |
| PROVIDER: | scopus |
| PUBMED: | 26910656 |
| PMCID: | PMC5064829 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 4 April 2016 -- Source: Scopus |
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