A Systematic Review of the Clinical Evidence to Guide Treatment Recommendations in Breast Reconstruction Based on Patient- Reported Outcome Measures and Health-Related Quality of Life

Winters, Zoë; Benson, John R.; Pusic, Andrea L.

doi:10.1097/sla.0b013e3181e623db

Cited by 109 publications

(117 citation statements)

References 77 publications

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“…[35][36][37][38] Thus, the assessment of patient outcomes using appropriately constructed and validated instruments is essential to evaluate and quantify the success of these surgeries from the patient's perspective. 39,40 By using specific patient-reported measures, such as the BREAST-Q, the HADS (for measuring general distress), and the IES (for capturing cancer-specific distress), we have analyzed Hr-QOL and satisfaction data in a prospective cohort of 55 patients who underwent free MS-TRAM or DIEP flap breast reconstruction.…”

Section: Discussionmentioning

confidence: 99%

Patient satisfaction and health‐related quality of life after autologous tissue breast reconstruction

Zhong

McCarthy

Min

et al. 2011

Cancer

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were asked to complete the BREAST-Q, Hospital Anxiety and Depression Scale (HADS), and Impact of Event Scale (IES) questionnaires before surgery and at 3 weeks and 3 months after surgery. A repeated-measures design was used to compare scores between baseline and postoperative time points. RESULTS: Fifty-one of 55 women completed the questionnaires (response rate, 93%). BREAST-Q subscale scores (breast, sexual well being, and psychosocial well being) improved significantly (P < .05) postoperatively. The other subscale scores related to physical well being of the chest and abdomen dropped significantly 3 weeks after reconstruction; and, by 3 months after reconstruction, both scores improved significantly (P < .05). Large effect sizes for improvements in satisfaction, psychosocial well being, and sexual well being were observed (1.88, 1.2, and 1.31, respectively); whereas deterioration in the effect size for abdominal donor site was reported (À1.56). After adjusting for postoperative complications, there were statistically significant changes in BREAST-Q subscale scores. Changes observed on the HADS and IES provided external validation of the findings obtained on the BREAST-Q. CONCLUSIONS: The current results suggested that the gains in breast satisfaction, psychosocial well being, and sexual well being after patients undergo either free muscle-sparing transverse rectus abdominis myocutaneous flap reconstruction or deep inferior epigastric artery flap reconstruction are statistically significant and clinically meaningful to the patient as early as 3 weeks after surgery. However, these gains are accompanied by significant deterioration in physical well being of the abdominal donor site. Cancer 2012;118:1701-

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Section: Discussionmentioning

confidence: 99%

Patient satisfaction and health‐related quality of life after autologous tissue breast reconstruction

Zhong

McCarthy

Min

et al. 2011

Cancer

Self Cite

176

100

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“…reconstruction with expander / prosthesis, the reconstruction with muscle flaps, reconstruction with autologous tissue and mixed techniques [2,7].…”

Section: Resultsmentioning

confidence: 99%

“…The quality of physical life can be affected in patients with mastectomy depending on the moment of reconstruction (immediate or deferred), the use of muscular flap and the lymphadenectomy [7]. The postoperative complications, the use of radiotherapy or chemotherapy can also affect the quality of life negatively [7,15].…”

Section: Discussionmentioning

confidence: 99%

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The Use of the Latissimus dorsi Flap in Breast Reconstruction of Post- Mastectomy Patients: Is Superior to the Use of Expander / Prosthesis?

Gómez-Sánchez¹

2016

J Aesthet Reconstr Surg

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“…31,32 Post-decisional regrets were observed more frequently in our study when the decision-making was not felt to be sufficiently proactive and in those who were less satisfied with their Breast Reconstruction. The impact of shared decision-making is certainly worth investigating in this context 34,35 with facilitating interventions. 36,37 The main limitation of our study was that some of the sub-groups, such as the PIP Breast Implant and the autologous Breast reconstruction sub-groups, were very small, which reduced the statistical power of some of the analyses.…”

Section: Iv-logisticmentioning

confidence: 99%

Impact of the Poly Implant Prosthesis Breast Implants Recall in Women With Breast Reconstruction: A South-Eastern French Cross-Sectional Survey Nested in a Prospective Cohort

Julian‐Reynier¹,

Bouhnik²,

Reynier³

et al. 2016

Women Health Open J

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The Poly Implant Prosthesis (PIP) Breast Implants crisis involved thousands of women in the countries concerned, women with breast cancer in particular. It was proposed here to investigate the impact of the PIP Breast Implants recall on women who had undergone Breast Reconstruction at the time of the recall and to analyze the determinants of their Breast Reconstruction decisional outcomes. A cross-sectional telephone survey was performed nested in prospective geographically based cohorts, which consisted of women from the southeastern France with breast cancer. Women were selected who had Breast Reconstructive surgery just before the PIP recall occurred. Dependent variables were the Psychological Impact of the event, Decisional Regret, and Satisfaction with Breast Reconstruction. Determinants of regret and satisfaction were analyzed using simultaneous equations. Among the 148 eligible women, 113(76%) participated. At the initial reconstruction, 90% (n=102) had a Breast Implant, 10% (n=11) had an autologous reconstruction. The PIP recall induced less intrusive thoughts, measured with the Impact of the Event Scale, in the non-PIP groups compared to the PIP one (p=0.025). Regrets about Breast Reconstruction were expressed by 57%; they occurred more frequently when the decision-making was not felt to be sufficiently proactive (adjusted Odds Ratio (ORadj) 5.1; 95% Confidence Interval (CI) (1.2-20.9)) and in those who were dissatisfied with their Breast Reconstruction (ORadj 0.7(95% CI (0.5-0.9))). Satisfaction was significantly lower in women with a Breast Implant, those whose trust in doctors had decreased, in the information-seekers and in less health-literate women. The PIP recall was not found to affect intrusive ideas or denial in women who did not have a PIP Breast Reconstruction. The high frequency of regrets could be reduced by involving women more strongly in the initial decision-making process. Using existing data-bases to assess the impact of new devices on patients' health is an option which organization deserves to be discussed.

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A Systematic Review of the Clinical Evidence to Guide Treatment Recommendations in Breast Reconstruction Based on Patient- Reported Outcome Measures and Health-Related Quality of Life

Cited by 109 publications

References 77 publications

Patient satisfaction and health‐related quality of life after autologous tissue breast reconstruction

Patient satisfaction and health‐related quality of life after autologous tissue breast reconstruction

The Use of the Latissimus dorsi Flap in Breast Reconstruction of Post- Mastectomy Patients: Is Superior to the Use of Expander / Prosthesis?

Impact of the Poly Implant Prosthesis Breast Implants Recall in Women With Breast Reconstruction: A South-Eastern French Cross-Sectional Survey Nested in a Prospective Cohort

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