Patient reported outcome measures (PROMs) following mastectomy with breast reconstruction or without reconstruction: a systematic review

Cordova, Leonardo Zandavalli; Hunter-Smith, David J.; Rozen, Warren M.

doi:10.21037/gs.2019.07.02

Cited by 45 publications

(44 citation statements)

References 65 publications

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“…Other versions of the BREAST‐Q have been developed for different surgery types such as breast conservation, mastectomy, and breast reconstruction, which permits comparison between various groups. As such, the BREAST‐Q has become an important indicator for success of cosmetic and reconstructive breast surgery 8 . Other validated PROMs, such as the European organization for research and treatment of cancer‐Q30 (EORTC‐Q30), 9 EORTC‐Q23, 10 Patient‐Reported Outcomes Measurement Information System (PROMIS), 11 and Medical Outcomes Study Short Form‐36 (SF‐36), 12 have also been useful for health‐related quality of life assessment in breast cancer patients.…”

Section: Introductionmentioning

confidence: 99%

A comprehensive literature review of patient‐reported outcome measures (PROMs) among common breast reconstruction options: What types of breast reconstruction score well?

et al. 2021

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Purpose Breast cancer continues to be the most prevalent cancer affecting women. Many reconstructive options exist after oncologic resection. Breast reconstruction can have a lasting impact on many areas of the patient's life, and therefore, a high consideration for patient satisfaction is crucial. Patient‐reported outcome measures (PROMs) provide an important tool in the evaluation of different surgical methodologies. The aim of this comprehensive systematic review is to look at various surgical modalities in breast reconstruction as they relate to patient satisfaction. Methods A PubMed PRISMA search was performed. Criteria for inclusion included nipple‐sparing or skin‐sparing mastectomy with autologous or implant‐based reconstruction, level 2 volume displacement or volume replacement oncoplastic surgery, and measurement of patient‐reported outcomes using the BREAST‐Q or other validated PROMs. From the data set, weighted proportions were generated and analyzed using the Kruskal‐Wallis rank sum test and a post hoc Dunn's test. Results After obtaining 254 full text copies, 43 articles met inclusion criteria and were included. Analysis of BREAST‐Q data showed oncoplastic breast surgery was significantly preferred over mastectomy regardless of the type of reconstruction. Nipple‐sparing was significantly preferred over skin‐sparing mastectomy, autologous reconstruction was significantly preferred over implant‐based reconstruction, and prepectoral implant placement was preferred over subpectoral implant placement. Validated PROMs other than BREAST‐Q showed similar trends in all but type of mastectomy. Conclusions In this comprehensive systematic review, oncoplastic surgery showed the most favorable PROMs when compared to other reconstructive modalities. Autologous was preferred over implant‐based reconstruction, and prepectoral was preferred over subpectoral implant placement.

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Section: Introductionmentioning

confidence: 99%

A comprehensive literature review of patient‐reported outcome measures (PROMs) among common breast reconstruction options: What types of breast reconstruction score well?

et al. 2021

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“…After controlling for covariates, the presence of a psychiatric diagnosis resulted in a decrease in module score of 9 points. In comparison, the mean benefit of any reconstruction on Psychosocial Wellbeing is an increase of 8 points and 11 points for Sexual Wellbeing 3 . While these findings are not unexpected, this study represents the first large scale cohort study to specifically evaluate psychiatric diagnoses' impact on patient satisfaction.…”

Section: Discussionmentioning

confidence: 64%

“…Breast reconstruction following mastectomy improves patients' well‐being, self‐image, and sexuality 1,2 . Furthermore, it can restore a patient's psychosocial and sexual health 3 . The BREAST‐Q questionnaire is a validated patient‐reported outcome measure to assess satisfaction and health‐related quality of life in breast surgery 4 .…”

Section: Introductionmentioning

confidence: 99%

Patients with psychiatric illness report worse patient‐reported outcomes and receive lower rates of autologous breast reconstruction

et al. 2020

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Psychiatric well‐being impacts on general satisfaction and quality of life. This study explored how the presence of psychiatric diagnoses affects patient‐reported outcomes in breast reconstruction and on selection of reconstructive modality. Patients who received breast reconstruction at a tertiary hospital between 2013 and 2018 and completed the BREAST‐Q survey were included. BREAST‐Q module scores were compared between patients who had a psychiatric diagnosis at presentation and the remaining cohort using t tests. General linear models (GLMs) were used to control for confounding factors. A chi‐squared test was used to assess the effect on reconstructive modality, and binary logistic regression was used to control for confounding factors. Of the 471 patients included, 93 (19.7%) had at least one psychiatric diagnosis. Cohorts did not differ significantly by age, BMI, race, ASA classification, or insurance status. Patients with a psychiatric diagnosis experienced a decrease in BREAST‐Q scores for the Psychosocial Wellbeing (B = 9.16, P = .001) and Sexual Wellbeing (B = 9.29, P = .025) modules. On binary logistic regression, patients with a psychiatric diagnosis were less likely to receive autologous reconstruction compared with implant reconstruction (OR = 0.489, P = .010). The presence of psychiatric diagnoses is an independent predictor of decreased BREAST‐Q. Furthermore, there is a significant disparity in modality of reconstruction given to patients with psychiatric diagnoses. Further study is needed to evaluate interventions to improve satisfaction among at‐risk populations and evaluate the reason for low autologous reconstruction in this population.

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“…24,25 The autonomous desires of patients should always be respected, especially with demonstrably improved patient-reported outcome measures with breast reconstruction following mastectomy when compared with mastectomy alone. 26 However, performing immediate reconstruction exposes the patient, surgical, anesthetic, and nursing teams to increased risk of SARS-CoV-2 transmission. Immediate reconstruction could thus harm multiple patients with COVID-19 exposure and place health care workers in peril through irresponsible use of resources, while performing mastectomy alone, asks the patient to consent to risks of additional future surgery and anesthesia.…”

Section: Oncologic Reconstructionmentioning

confidence: 99%

Plastic Surgery in the Time of COVID-19

Chi

Chen

Dorante

et al. 2020

J Reconstr Microsurg

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Background The novel coronavirus disease 2019 (COVID-19) has swept the world in the last several months, causing massive disruption to existing social, economic, and health care systems. As with all medical fields, plastic and reconstructive surgery has been profoundly impacted across the entire spectrum of practice from academic medical centers to solo private practice. The decision to preserve vital life-saving equipment and cancel elective procedures to protect patients and medical staff has been extremely challenging on multiple levels. Frequent and inconsistent messaging disseminated by many voices on the national stage often conflicts and serves only to exacerbate an already difficult decision-making process. Methods A survey of relevant COVID-19 literature is presented, and bioethical principles are utilized to generate guidelines for plastic surgeons in patient care through this pandemic. Results A cohesive framework based upon core bioethical values is presented here to assist plastic surgeons in navigating this rapidly evolving global pandemic. Conclusion Plastic surgeons around the world have been affected by COVID-19 and will adapt to continue serving their patients. The lessons learned in this present pandemic will undoubtedly prove useful in future challenges to come.

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Patient reported outcome measures (PROMs) following mastectomy with breast reconstruction or without reconstruction: a systematic review

Cited by 45 publications

References 65 publications

A comprehensive literature review of patient‐reported outcome measures (PROMs) among common breast reconstruction options: What types of breast reconstruction score well?

A comprehensive literature review of patient‐reported outcome measures (PROMs) among common breast reconstruction options: What types of breast reconstruction score well?

Patients with psychiatric illness report worse patient‐reported outcomes and receive lower rates of autologous breast reconstruction

Plastic Surgery in the Time of COVID-19

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