P2-16-08: Expander-Implant-Reconstruction – Aesthetic Outcome and Patients' Satisfaction in a 10-Year-Period.

Abstract

Background. Breast reconstruction after mastectomy is gaining increasing significance avoiding the post-mastectomy-trauma and providing the patients with a normal body image after breast cancer survival. This study was conducted to investigate the patients’ characteristics and comorbidities in correlation with the surgical outcome of expander-implant-reconstruction after mastectomy. Patients’ satisfaction with the surgical result and self-perception as well as their partner interaction were also analyzed in their dependance of these patient-related data. Methods. In this large retrospective cohort study 258 women were enrolled with expander- and/or implant-reconstruction in a single-institution-setting of a 10-years-period (2000-2009). Patient's satisfaction with the result of surgery was evaluated by questionnaires and interviews and patient-related data were retrieved like BMI, smoking, pre-existing diseases and chemo- and radiotherapy, the differentiation between one-stage/two-stage reconstruction, immediate/delayed reconstruction, antibiotics and complications (secondary bleeding, pain, capsular contracture, implant rotation, etc.). Finally, the patients’ interaction with their partners and their adhaerence to their decision for reconstruction was investigated. For explorative statistical analyses we used standard univariate methods appropriately for the scale level of the variables (e.g. Fishers exact tests for n x m Tables or exact Wilcoxon Mann Whitney tests to compare two distributions) and applied a significance level a of 5% to each test. Results: BMI and patients’ satisfaction with the aesthetic result was inversely correlated (p=0,004) and a negative self-perception had a negative impact on interaction with the partner (p<0,001) after breast reconstruction. BMI was positively correlated with the loss of the implant (p=0,005). Further comorbidities led to worse patients’ satisfaction in rating of the aesthetic results. Conclusion: Patients characteristics like obesity and other comorbidites are associated with lower patients’ satisfaction with the surgical outcome after expander-implant-breast reconstruction. A decrease of satisfaction is detectable after expander-implant reconstruction within years compared to autologous reconstruction. These results should be taken into consideration for counselling of patients opting for breast reconstruction after mastectomy. This is to our knowledge the largest single-institution study evaluating the patients’ satisfaction with implant-reconstruction after breast cancer treatment and comparing the outcome with various patient characteristics giving a rationale for selection of the optimal reconstructive method. Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P2-16-08.