Long-Term Patient Satisfaction and Quality of Life Following Breast Reconstruction Using the BREAST-Q: A Prospective Cohort Study

Shiraishi, Makoto; Sowa, Yoshihiro; Tsuge, Itaru; Kodama, Takuya; Inafuku, Naoki; Mmorimoto, Naoki

doi:10.3389/fonc.2022.815498

Cited by 17 publications

(7 citation statements)

References 72 publications

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“…The operative planning and decision-making process regarding one-or two-stage reconstruction and whether to use a pedicled or free NAC graft are crucial in achieving an aesthetically pleasing outcome. Although the primary goal is to remove at-risk breast tissue, the long-term cosmetic outcome has also been demonstrated to have a strong impact on patients' quality of life [6,[16][17][18][19][20][21]. The aim of this paper is to provide a review of the current literature on prophylactic mastectomy and autologous reconstruction in patients with large and ptotic breasts and an overview of the techniques used at our institution, which may help inform clinical decision-making and improve the quality of care for this challenging group of patients.…”

Section: Discussionmentioning

confidence: 99%

Mastopexy Strategies for Ptotic Breasts in Patients Choosing Autologous Reconstruction Following Prophylactic Mastectomy

Varnava

Bogusch

Wellenbrock

et al. 2023

JCM

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Background: Autologous breast reconstruction is a reliable solution for many patients after mastectomy. While this technique represents a standardized approach in many patients, patients with ptotic breasts may require a combination of procedures to achieve an aesthetically pleasing result. Methods: We reviewed the mastectomy and free-flap breast reconstruction procedures performed at our institution from 2018 to 2022 in patients with ptotic breasts. The technique used to address the ptosis was put in focus as we present the four strategies used by our reconstructive surgeons. We performed two different one-stage and two different two-stage procedures. The difference between the two-stage procedures was the way the nipple areola complex was treated (inferior dermal pedicle or free skin graft). The difference between the one-stage procedures was the time of execution of the mastopexy/breast reduction (before or after the mastectomy and autologous breast reconstruction). Results: The one-stage procedure was performed with a free NAC in three patients and with a pedicled NAC in five patients. The two-stage procedure was performed in seven patients, with six of them undergoing mastopexy before and one patient undergoing mastopexy after the bilateral mastectomy and autologous reconstruction. No flap loss or total loss of the nipple areola complex occurred. Partial NAC loss was observed in five breasts in the single-stage group without any occurrence in the double-stage group. Conclusions: While both one- and two-stage procedures were performed in a safe fashion with satisfactory results at our institution, larger trials are required to determine which procedure may yield the best possible outcomes. These outcomes should also include oncological safety and patient-reported outcomes.

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Section: Discussionmentioning

confidence: 99%

Mastopexy Strategies for Ptotic Breasts in Patients Choosing Autologous Reconstruction Following Prophylactic Mastectomy

Varnava

Bogusch

Wellenbrock

et al. 2023

JCM

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“…Validity is supported by inter-scale correlations, convergent and divergent hypotheses. License to use Breast-Q has been acquired and the scales have been translated in Urdu language in accordance and after approval from MAPI trust ( https://mapi-trust.org/questionnaires/ ) and the above two mentioned institutes 16 , 17 . However, Breast-Q–Breast cancer core scale (Postoperative version) for BCS evaluate only satisfaction with breasts and physical well-being in patients, sexual and psychosocial is not applicable to BCS group.…”

Section: Methodsmentioning

confidence: 99%

Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study

Vohra¹,

Javed

Jabeen

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: Quality of life after breast cancer surgery is frequently ignored during and after treatment in many cancer survivors. To enhance this aspect of patient’s life should be the primary goal of every cancer treatment. Therefore, the present study aimed to highlight the quality of life and patients’ satisfaction with their breast cosmesis following breast conserving surgery (BCS), total mastectomy with and without reconstruction. Material and methods: Data were collected prospectively from cancer patients who had undergone breast surgery at our institution from 1 January 2015 to 31 December 2021. The validated Breast-Q questionnaires were utilized for conducting patient interviews and mean scores between three cohorts were compared using one-way ANOVA test / Kruskal–Wallis test. Results: Overall, 210 patients were recruited in which 70 patients (33.3%) had undergone BCS, 71 patients (33.8%) had total mastectomy only and 69 (32.9%) patients had total mastectomy with reconstruction. Physical well-being scores were consistent between the three groups while patients operated with total mastectomy with reconstructive surgery scored higher in sexual and psychosocial health measures as compared to patients of total mastectomy. However, BCS patients were the most satisfied with their cosmetic outcome following patients of total mastectomy with reconstruction and without reconstruction. Conclusion: Reconstruction postmastectomy has a positive impact on sexual and psychosocial well-being of survivors; however, those who had breast conservation were more satisfied with cosmetic outcome post-surgery as compared with mastectomy with or without reconstruction.

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“…The scars from latissimus dorsi and TRAM flap surgery have been typically hidden by underwear. However, as the importance of quality of life, diverse lifestyles, and leisure activities has increased, the visibility of these scars has become a more pressing issue to address [7][8][9][10]. In this study, we employed the different oblique planes closure technique as an alternative to the traditional vertical single plane method for donor site closure in island TRAM flap surgery patients.…”

Section: Introductionmentioning

confidence: 99%

Abdominal closure with different oblique planes in island TRAM flaps: a method for achieving a better scar and contour of the donor site

Kim,

Kim

et al. 2024

Arch Aesthetic Plast Surg

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Background An autologous abdominal flap can provide an aesthetically pleasing breast with a natural feel. However, contracted scars and hourglass contour deformities at the abdominal donor site can sometimes occur. These complications can reduce patient satisfaction and quality of life. Therefore, we performed different oblique plane closure of the abdominal donor site and evaluated the aesthetic scores in comparison with the conventional vertical single plane closure.Methods The procedures begin with a beveled incision down to the fascia level during transverse rectus abdominis muscle flap elevation. At the time of donor site closure, Scarpa’s fascia and the subcutaneous layers are sutured while being pulled downward. Sixty patients were divided into two groups: group A (single vertical plane closure) and group B (different oblique plane closure). Abdominal scars were scored by five reviewers using the scar scale.Results There were no significant differences in scores for vascularization, dog-ear presence, and umbilical shape of the scar between the two groups. However, group B showed marked improvements in flatness, contracture, and thickness of the scar surface. Notably, the different oblique plane closure in group B achieved much higher scores for the abdominal contour than group A.Conclusions The vertical single plane suture of the abdominal donor site may result in depressive contracture with poor cosmetic outcomes. The different oblique plane closure technique markedly improved the appearance of scars on the abdomen. This technique is likely to enhance patient satisfaction with both the breast and abdominal outcomes of breast reconstruction using an abdominal flap.

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Long-Term Patient Satisfaction and Quality of Life Following Breast Reconstruction Using the BREAST-Q: A Prospective Cohort Study

Cited by 17 publications

References 72 publications

Mastopexy Strategies for Ptotic Breasts in Patients Choosing Autologous Reconstruction Following Prophylactic Mastectomy

Mastopexy Strategies for Ptotic Breasts in Patients Choosing Autologous Reconstruction Following Prophylactic Mastectomy

Quality of life of breast cancer survivors: a comparison of breast conserving surgery versus total mastectomy with and without immediate reconstruction: a prospective cohort study

Abdominal closure with different oblique planes in island TRAM flaps: a method for achieving a better scar and contour of the donor site

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