Patient-Reported Outcomes Following Breast Reconstruction With the Transverse Myocutaneous Gracilis Flap Using the BREAST-Q and Lower Extremity Function Scale

Abstract

Background The Transverse Myocutaneous Gracilis (TMG) flap is a viable and safe option for breast reconstruction in patients with limited abdominal tissue or other contraindications for abdominal based flaps. Although it is one of the most commonly used flaps for breast reconstruction, data on patient reported outcome is limited. Objectives The authors seek to evaluate patient satisfaction and aesthetic outcome after breast reconstruction with the TMG flap. Methods All patients who underwent breast reconstruction with a TMG flap between March 2010 and October 2020 were identified. Invitation to a digital version of the BREAST-Q reconstructive module and the Lower Extremity Function Scale (LEFS) was sent to 105 patients. Patient demographics, complications and surgical details were collected and retrospectively analyzed. BREAST-Q and LEFS scores were calculated and compared to the literature. Results Eighty-two patients participated in the study. Median follow-up was 5.9 years with a median patient age of 45.7 years. Most patients (90.2 percent) received treatment due to previous cancer of the breast and 17.1 percent underwent immediate reconstruction. The mean score for “Satisfaction with Breast” was 66/100. Postoperative lower extremity function was high with a mean LEFS score of 78/80. A LEFS score below median value was found to be significantly associated with active smoking (p=0.049). Patients also reported high satisfaction with donor-sites (8/11). Conclusions Patient satisfaction and aesthetic outcome after breast reconstruction with TMG flaps is high and comparable to other common techniques. Lower extremity function is not impaired after flap harvest.