Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction

Abstract

At 2 years, patients who underwent autologous reconstruction were more satisfied with their breasts and had greater psychosocial well-being and sexual well-being than did those who underwent implant reconstruction. These findings can inform patients and their clinicians about expected satisfaction and quality of life outcomes of autologous vs implant-based procedures and further support the adoption of shared decision making in clinical practice.

A systematic review of factors affecting quality of life after postmastectomy breast reconstruction in women with breast cancer

“…Two studies assessed the role of time after reconstruction on these patients' quality of life. Santosa et al, found that psychosocial, physical, and sexual well‐being increased with time after this surgery. However, Matthews and colleagues did not find this variable to be a significant predictor of quality of life.…”

“…Regarding the type of mastectomy, three studies out of four (75%) found that patients who underwent nipple‐sparing mastectomy reported significantly higher psychosocial and sexual well‐being, when compared with non‐nipple‐sparing surgeries. Skin sparing mastectomy has also been found to better preserve physical well‐being (in the chest), compared with modified radical mastectomy …”

“…Nine studies out of 20 (45%) reported results favoring autologous procedures for psychosocial and sexual well‐being . Some studies also differentiated between different types of autologous procedures, favoring DIEP flaps over TRAM for psychosocial and physical well‐being on the abdomen .…”

“…Four studies out of six (67%) reported that chemotherapy was associated with low levels of psychosocial, sexual, and social function, and an overall lower quality of life . One study found that patients who underwent immunotherapy presented higher odds of having lower psychosocial and sexual well‐being …”

Organization of Multidisciplinary Cancer Care for the Surgical Patient: Role of Anesthesiologists

“…Future research at MSKCC will continue to focus on the implementation and success of cancer ERPs, evaluating their role in the optimization of postoperative outcomes, including patient-reported outcome measures (PROMs). One PROM assessing long-term outcomes within the surgical oncology population is the BREAST-Q, a validated, condition-specific, patient-reported outcome instrument, which measures satisfaction and breast-related quality of life associated with breast reconstructive techniques [38]. Similar patient-centric objective measures of quality of life may be employed to capture the perioperative patient experience in the setting of multidisciplinary efforts to impact cancer outcomes.…”