Quality-of-Life Outcomes Improve with Nipple-Sparing Mastectomy and Breast Reconstruction

Bailey, Christopher R.; Ogbuagu, Onyebuchi U.; Baltodano, Pablo A.; Simjee, Usamah F.; Manahan, Michele A.; Cooney, Damon S.; Jacobs, Lisa K.; Tsangaris, Theodore N.; Cooney, Carisa M.; Rosson, Gedge D.

doi:10.1097/prs.0000000000003505

Cited by 117 publications

(100 citation statements)

References 22 publications

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“…Regarding the type of mastectomy, three studies out of four (75%) found that patients who underwent nipple‐sparing mastectomy reported significantly higher psychosocial and sexual well‐being, when compared with non‐nipple‐sparing surgeries. Skin sparing mastectomy has also been found to better preserve physical well‐being (in the chest), compared with modified radical mastectomy …”

Section: Resultsmentioning

confidence: 99%

“…Two studies out of three (67%) found that higher levels of prereconstruction quality of life were significant predictors of higher levels of overall quality of life and its dimensions such as psychosocial, physical, and sexual well‐being …”

Section: Resultsmentioning

confidence: 99%

“…37,39 Lastly, one study 10 also found that patients who took anxiolytics also presented higher odds of having lower sexual well-being after breast reconstruction. Two studies out of three (67%) found that higher levels of prereconstruction quality of life were significant predictors of higher levels of overall quality of life 36 and its dimensions such as psychosocial, physical, and sexual well-being. 32,37 The association between depression symptoms and quality of life was identified by two studies.…”

Section: Patients Clinical Characteristicsmentioning

confidence: 99%

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A systematic review of factors affecting quality of life after postmastectomy breast reconstruction in women with breast cancer

et al. 2019

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Objective The aim of this study is to present a broader perspective of factors affecting the quality of life after postmastectomy breast reconstruction in women with breast cancer by considering these patients' self‐reported outcomes. Methods The search was performed from 29 March to 19 April 2019, on the following databases: PsycInfo; Web of Science Core Collection, Current Contents Connect, Derwent Innovations Index, KCI‐Korean Journal Database, Russian Science Citation Index, SciELO Citation Index, and MEDLINE. The studies were included if they identified factors affecting self‐reported quality of life after breast reconstruction, in women with breast cancer. Results One hundred and twenty‐two records were identified. After quality assessment, 44 studies were included for qualitative synthesis. This review comprised a total of 16 683 women who underwent breast reconstruction. The results identified a broad collection of 32 empirically based variables associated with several domains of quality of life. These variables were grouped into four categories: (a) surgical, (b) clinical, (c) psychosocial, and (d) sociodemographic variables. Conclusions This systematic review goes beyond surgical factors of morbidity and uses patient‐reported outcomes to scope wider issues that influence quality of life, such as psychosocial and sociodemographic variables. It sustains the need to adopt a more holistic approach and advises the consideration of preoperative psychosocial factors to better understand these patients' quality of life after breast reconstruction and to implement future preventive measures.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Patients Clinical Characteristicsmentioning

confidence: 99%

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A systematic review of factors affecting quality of life after postmastectomy breast reconstruction in women with breast cancer

et al. 2019

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“…With primary implant reconstruction, NSM has become the best treatment option for women requiring mastectomy due to better cosmetic result, greater satisfaction, and better quality of life compared to modified radical mastectomy or skin-sparing mastectomy [5,6]. Breast reconstructions are subject to possible early postoperative complications related to either wound healing or flap viability that can lead to prolonged convalescent periods, albeit without causing significant delays in adjuvant chemotherapy or radiotherapy [7,8,9].…”

Section: Introductionmentioning

confidence: 99%

Nipple-Sparing Mastectomy with Primary Implant Reconstruction: Surgical and Oncological Outcome of 435 Breast Cancer Patients

et al. 2018

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Background: This study aimed to examine the incidence of surgical complications associated with nipple-sparing mastectomy (NSM) with primary implant reconstruction, analyze risk factors for early and late surgical complications of NSM, and determine the incidence of local recurrences and the safety of sparing the nipple-areola complex (NAC). Methods: This retrospective cohort study included 435 patients with 441 NSM procedures over a period of 9 years (2004-2012). All surgical complications and the oncological outcome were recorded during follow-up. Results: The most common early surgical complication was skin flap ischemia/necrosis (26 patients, 5.9%). Prosthesis explantation due to complications was carried out in 11 (2.5%) cases. Neoadjuvant chemotherapy, implant size >500 ml, diabetes mellitus, body mass index > 25 kg/m², and incisions other than lateral were risk factors for early complications (p < 0.001). The NAC excision rate was 5.4% (24 cases) due to confirmed presence of cancer cells in the subareolar tissue. Capsular contracture as a late complication occurred in 33 (7.48%) cases. Local relapse occurred in 32 (7.3%) patients. Distant metastases were diagnosed in 68 (15.6%) patients, and 53 (12.2%) patients died during the follow-up period. Conclusions: NSM with immediate implant reconstruction has an acceptable morbidity rate and is an oncologically and surgically appropriate treatment for most women requiring mastectomy.

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“…Nipple-areola complex preservation positively impacts the patient's quality of life and helps them in achieving a better psychological and sexual well-being, as well as higher satisfaction with regard to their reconstruction. 24,25 The first choice and most favorable NSM incision is the lateral inframammary fold (IMF), as it permits good visualization for the mastectomy and is the least noticeable on frontal view. 23 While large breasts pose a challenge for the oncologic surgeon, this incision has been associated with the lowest rate of nipple necrosis in the literature.…”

Section: Mastectomy Incision Typementioning

confidence: 99%

Update in Direct-to-Implant Breast Reconstruction

Perdanasari

Abu‐Ghname

Raj

et al. 2019

Seminars in Plastic Surgery

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Implant-based reconstruction (IBR) remains the most commonly utilized breast reconstruction option for post-mastectomy patients. IBR can be approached as either a one-stage reconstruction or a two-stage reconstruction. Facilitated by improvements in surgical technology and advanced techniques, one-stage reconstruction, also known as direct-to-implant (DTI) reconstruction, involves the insertion of an implant at the time of mastectomy. The decision to pursue either a DTI or a two-stage reconstruction is based on several factors, including the patient's overall health, expected risk of postoperative complications, and associated costs to both the patient and hospital.

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Quality-of-Life Outcomes Improve with Nipple-Sparing Mastectomy and Breast Reconstruction

Abstract: Therapeutic, III.

Cited by 117 publications

References 22 publications

A systematic review of factors affecting quality of life after postmastectomy breast reconstruction in women with breast cancer

A systematic review of factors affecting quality of life after postmastectomy breast reconstruction in women with breast cancer

Nipple-Sparing Mastectomy with Primary Implant Reconstruction: Surgical and Oncological Outcome of 435 Breast Cancer Patients

Update in Direct-to-Implant Breast Reconstruction

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