Nipple-sparing bilateral prophylactic mastectomy and immediate reconstruction with TiLoop® Bra mesh in BRCA1/2 mutation carriers: A prospective study of long-term and patient reported outcomes using the BREAST-Q

Casella, Donato; Taranto, Giuseppe Di; Marcasciano, Marco; Sordi, S.; Kothari, Ashutosh; Kovács, Tibor; Torto, Federico Lo; Cigna, Emanuele; Ribuffo, Diego; Calabrese, Claudio

doi:10.1016/j.breast.2018.02.001

Cited by 56 publications

(45 citation statements)

References 30 publications

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“…Complication rates in this series were overall low and compared favorably to prior studies on BP‐NSM . Though not regarded as a “major” complication, issues such as partial‐thickness necrosis or minor infections that occurred in these patients can still be serious setbacks in a young patient population undergoing elective surgery with established postoperative difficulties with body image.…”

Section: Discussionsupporting

confidence: 62%

“…At an average follow‐up of 37 months, 19% of patients required revision procedures. Casella et al reported similar revision rates with 16% of patients who underwent BP‐NSM and prepectoral immediate implant placement requiring fat grafting after one year . Capsular contracture rates in this series were low; however, longer follow‐up is needed to evaluate this outcome.…”

Section: Discussionsupporting

confidence: 54%

“…In 2015, Metcalfe reported high BREAST‐Q scores in patients that underwent BP‐NSM . More recently, Casella et al demonstrated significant improvement in BREAST‐Q scores after BP‐NSM . No prior studies, however, have examined satisfaction and quality of life in young adults (average patient age in the prior studies was 41.5 and 43.2, respectively).…”

Section: Discussionmentioning

confidence: 99%

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Prophylactic nipple‐sparing mastectomy in young previvors: Examining decision‐making, reconstructive outcomes, and patient satisfaction in BRCA+ patients under 30

et al. 2019

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Breast J. 2020;26:971-975. wileyonlinelibrary.com/journal/tbj | 971 A retrospective chart review of high-risk young adult females undergoing BPM from 2006 to 2018 was performed in combination with a survey administered to patients postoperatively (IRB #i18-00829). Patients were included if they a) had a known diagnosis of high-risk BRCA mutations, b) were under the age of 30 at time of surgery, Abstract Bilateral prophylactic mastectomies (BPM) in young previvors with high-risk mutations are rising; however, little data on management, therapy timing, and outcomes exist. BRCA+ patients under 30 undergoing BPM from 2006 to 2018 were reviewed. Twenty-two patients aged 23-29 underwent mastectomy 4.2 years after genetic diagnosis. Twelve patients completed surveys, most often citing personal decisions (50%) for undergoing mastectomy and plastic surgeons' recommendations (83.3%) for reconstruction. About 73% of patients completely understood risks/benefits of mastectomy and 63.6% of reconstruction. Patients reported high BREAST-Q Satisfaction and Well-Being scores. Continued educational resource development will optimize shared decision-making in the reconstructive process.

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Section: Discussionsupporting

confidence: 62%

Section: Discussionsupporting

confidence: 54%

Section: Discussionmentioning

confidence: 99%

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Prophylactic nipple‐sparing mastectomy in young previvors: Examining decision‐making, reconstructive outcomes, and patient satisfaction in BRCA+ patients under 30

et al. 2019

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“…Patients tend to be more satisfied with the outcome of breast reconstruction compared to observers from the healthcare professions, with this rater role being generally played by surgeons 16,17 . This is expected, since both the BCCT.core program and the Harvard and modified Garbay scales concentrate on symmetry.…”

Section: Discussionmentioning

confidence: 98%

The cosmetic outcome of breast reconstruction: reproducibility of different methods assessed by different professionals

Bayeh¹,

Paulinelli²,

Soares³

et al. 2019

Mastology

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Objetivo: Comparar a reprodutibilidade de métodos diferentes de avaliação dos resultados estéticos de cirurgias reconstrutivas da mama, por avaliadores distintos. Métodos: Foram incluídas fotografias de 270 pacientes portadoras de neoplasia da mama que passaram por cirurgias reconstrutivas da mama. As notas da avaliação foram dadas por um cirurgião plástico, um residente em cirurgia plástica, dois mastologistas, dois residentes em mastologia e dois psicólogos. Foram utilizadas as escalas de Harvard e Garbay modificada e a nota objetiva do programa BCCT.core. Foram calculados os índice Kappa de concordância interobservador e de correlação de Spearman. Resultados: A média de idade das pacientes foi de 55,7 anos (±11,1). No geral, 145 (53,7%) mulheres foram submetidas a tratamento conservador com cirurgia oncoplástica e 125 (46,3%) passaram por mastectomia e reconstrução total. A média de tempo de seguimento foi de 63,7±45,6 meses. Para a escala de Harvard, houve uma reprodutibilidade interobservador razoável para os diferentes profissionais, enquanto na escala de Garbay, a reprodutibilidade foi pobre entre os profissionais. De forma geral, a nota dada pelo programa BCCT.core correlacionou-se moderadamente com a escala de Harvard e a de Garbay modificada. Conclusão: As escalas de Harvard e de Garbay modificada correlacionam-se igualmente de forma moderada com o teste objetivo (BCCT.core). A escala de Harvard tem menor variabilidade interobservador, se comparada com a escala de Garbay.PALAVRAS-CHAVE: neoplasias da mama; procedimentos cirúrgicos reconstrutivos; cirurgia plástica. RESUMO ABSTRACTObjective: To compare the reproducibility of different methods for assessing the cosmetic outcome of breast reconstruction, which was assessed by different health professionals. Methods: Photographs of 270 breast cancer patients who had been submitted to breast reconstruction of some type were included. A plastic surgeon, a resident in plastic surgery, two mastologists, two residents in mastology, and two psychologists performed the evaluation. The modified Garbay and Harvard scales and the objective BCCT. core software program were used. Cohen's Kappa and Spearman correlation coefficients were calculated. Results: The mean age of the patients was 55.7 (±11.1) years. Overall, 145 women (53.7%) underwent partial breast reconstruction and 125 (46.3%), total breast reconstruction. The mean follow-up time was 63.7±45.6 months. By applying the Harvard scale, the interobserver reproducibility among the different professionals was minimal; whereas the Garbay scale had no agreement. The correlations between the BCCT.core software program and the Harvard and modified Garbay scales were moderate. Conclusion: Correlations between both the modified Garbay scale and the Harvard scale and the objective (BCCT.core) test were moderate. There was less interobserver variability with the Harvard scale compared to the modified Garbay scale.

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“…However, most studies analyzing satisfaction and quality of life after BPM or CPM have only evaluated postoperative results. A few studies have recorded preoperative values which allow for sufficient evaluation [9][10][11]. The publication by McCarthy et al [8] reports a particularly important study.…”

Section: Introductionmentioning

confidence: 99%

Quality of Life after Bilateral and Contralateral Prophylactic Mastectomy with Implant Reconstruction

et al. 2020

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Background: Prophylactic mastectomy is an effective approach to breast cancer risk reduction in patients at high risk. Further studies using standardized measures for quality of life are needed to better understand the effect of prophylactic mastectomy on individual patients and, thereby, allow for better patient counseling and selection. Methods: In this prospective study patients undergoing bilateral mastectomy were asked to complete the BREAST-Q questionnaire before and 1 year after surgery. All patients underwent bilateral mastectomy with implant-based breast reconstruction. Patient- and surgery-related information was collected in a database. Results: In total, 48 patients underwent bilateral skin-sparing mastectomy. Of these, 29 (60.4%) suffered from breast cancer. A 2-stage reconstruction with intermediate expander implantation was conducted in 19 (39.6%) patients. All patients completed the BREAST-Q questionnaire. The domain “psychosocial well-being” was significantly improved from a mean score of 74.98 preoperatively to a postoperative score of 81.56 (p = 0.021). In contrast, the domain “physical well-being” dropped –8.38 points on average to a postoperative score of 74.96 (p < 0.001). Interestingly, patients with the lowest preoperative score in the domain “satisfaction with breast” showed the greatest increase after surgery (50.31 vs. 67.25, p < 0.001). On the contrary, patients with the highest preoperative values experienced the strongest decrease in satisfaction (91.60 vs. 75.27, p = 0.012). Conclusion: Implant-based prophylactic mastectomy leads to good quality-of-life results in patients at high risk for breast cancer. Especially, patients with a low preoperative satisfaction with their breasts have a significantly higher chance of experiencing substantial improvements in their quality of life.

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Nipple-sparing bilateral prophylactic mastectomy and immediate reconstruction with TiLoop® Bra mesh in BRCA1/2 mutation carriers: A prospective study of long-term and patient reported outcomes using the BREAST-Q

Cited by 56 publications

References 30 publications

Prophylactic nipple‐sparing mastectomy in young previvors: Examining decision‐making, reconstructive outcomes, and patient satisfaction in BRCA+ patients under 30

Prophylactic nipple‐sparing mastectomy in young previvors: Examining decision‐making, reconstructive outcomes, and patient satisfaction in BRCA+ patients under 30

The cosmetic outcome of breast reconstruction: reproducibility of different methods assessed by different professionals

Quality of Life after Bilateral and Contralateral Prophylactic Mastectomy with Implant Reconstruction

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