Autologous versus implant-based breast reconstruction: A systematic review and meta-analysis of Breast-Q patient-reported outcomes

Toyserkani, Navid Mohamadpour; Jørgensen, Mads Gustaf; Tabatabaeifar, Siavosh; Damsgaard, Tine Engberg; Sørensen, Jens Ahm

doi:10.1016/j.bjps.2019.09.040

Cited by 155 publications

(124 citation statements)

References 32 publications

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“…Women who underwent autologous based reconstruction were more satisfied than those who had implant-based reconstruction [ 150 ]. This is also concluded in a recent meta-analysis of 9 studies with more than 2000 implant-based reconstructions and approximately 1000 autologous breast reconstructions [ 151 ]. There was significantly higher satisfaction with the breast, higher satisfaction of outcome, higher psychosocial well-being, and higher sexual well-being in autologous reconstruction versus implant-based reconstruction.…”

Section: Surgical Procedures Associated With Female With Brca Mutationmentioning

confidence: 62%

“…There was significantly higher satisfaction with the breast, higher satisfaction of outcome, higher psychosocial well-being, and higher sexual well-being in autologous reconstruction versus implant-based reconstruction. There was a trend towards better physical well-being, but this was not significant [ 151 ].…”

Section: Surgical Procedures Associated With Female With Brca Mutationmentioning

confidence: 99%

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Management of patients with BRCA mutation from the point of view of a breast surgeon

Riis

2021

Annals of Medicine &Amp; Surgery

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Germ-line mutation in BRCA (BReast CAncer gene) 1 or BRCA2 are found in 3–4% of all women with breast cancer. These patients have a significant increased risk of breast and ovarian cancer. They are often younger when diagnosed with the mutation, and the possible breast cancer they get is often aggressive with inferior outcome. There are risk reducing strategies, and the most powerful strategy is risk reducing surgery, both risk reducing bilateral mastectomy (RRM) and risk reducing bilateral salpino-oophorectomy (PBSO). This review is meant to address breast surgery in patients with germline BRCA mutation. The guidelines and techniques applied is under continuous change and it is important for the clinicians to be well informed to provide the patient with the information needed for them to make an informed decision on what risk strategy to choose.

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Section: Surgical Procedures Associated With Female With Brca Mutationmentioning

confidence: 62%

Section: Surgical Procedures Associated With Female With Brca Mutationmentioning

confidence: 99%

Management of patients with BRCA mutation from the point of view of a breast surgeon

Riis

2021

Annals of Medicine &Amp; Surgery

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“…We observed a nearly 20% increase in the use of implant BR and a subsequent decrease in autologous BR over time. This is despite recent evidence of superior patient‐reported outcomes for autologous BR 31 . The need for reduced operative and recovery time may have contributed to the shift away from autologous BR.…”

Section: Discussionmentioning

confidence: 97%

Population‐based picture of breast reconstruction in Queensland, Australia

Youl

Philpot

Moore

et al. 2021

ANZ Journal of Surgery

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Background Approximately 40% of women with invasive breast cancer will undergo a mastectomy. Clinical practice guidelines recommend breast reconstruction (BR) options should be discussed with all women who are to undergo a mastectomy. We sought to examine rates of BR, BR methods over time and to identify factors associated with the likelihood of receiving BR in Queensland. Methods This population‐based study used linked data from the Queensland Oncology Repository for 12 364 women who underwent a mastectomy for invasive breast cancer from 2008 to 2017. Multivariate logistic regression was used to model predictors of immediate breast reconstruction (IBR) and delayed breast reconstruction (DBR). Results Overall, 2560 (20.7%) women had BR, with 9.8% having IBR and 10.9% having DBR. Factors associated with a reduced likelihood of IBR or DBR included older age (P < 0.001), living in a regional/rural area (P < 0.001) and having a mastectomy in a public versus private hospital (P < 0.001). Median time from mastectomy to DBR was 18.4 and 29.2 months for women attending a private versus public hospital, respectively (P < 0.001). Use of implant‐based BR increased significantly with a corresponding decrease in autologous BR over time. Conclusions Significant disparities exist in rates of BR between public and private hospitals. Women living in regional and rural areas as well as those aged over 60 years continue to have lower rates of BR. Addressing the health system barriers and developing strategies to improve access to, and uptake of BR should be a priority.

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“…So scheint neben einer verbesserten Funktionalität sogar ein Überlebensvorteil für mikrochirurgisch rekonstruierte Patienten zu resultieren [6]. Bei Brustrekonstruktionen konnte eine aktuelle Metaanalyse eine höhere Patientenzufriedenheit der autologen gegenüber den implantatbasierten Rekonstruktionen nachweisen [7]. Auch eine Gegenüberstellung der Gesamtkosten zeigte, dass die autologe Brustrekonstruktion langfristig wirtschaftlicher ist [8,9].…”

Section: Mehrwert Der Mikrochirurgischen Behandlung Gegenüber Anderenunclassified

Wirtschaftliche Aspekte in der Mikrochirurgie: Bericht zum Konsensus-Workshop der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße – (DAM)

Braig

Behr

Černý

et al. 2020

Handchir Mikrochir Plast Chir

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ZusammenfassungIm Zuge des zunehmenden Kostendrucks im Gesundheitssystem werden Therapien neben ihrer Qualität zunehmend auch hinsichtlich ihrer Wirtschaftlichkeit bewertet. Mikrochirurgische Eingriffe haben sich vor allem im Langzeitverlauf in vielen Bereichen als funktionell und ästhetisch überlegen gezeigt. Im Vergleich zu Alternativeingriffen sind sie aber auf Grund ihrer Komplexität sowie langen Operationszeiten und stationären Verweildauern mit hohen Kosten verbunden. Damit diese langfristig in hoher Qualität angeboten werden können, muss entsprechend von Seiten der Kostenträger, insbesondere auch bei interdisziplinären Eingriffen, eine adäquate, kostendeckende Vergütung erfolgen. Um einen korrekten DRG-Erlös zu erhalten sollten daher neben der Hauptdiagnose auch die relevanten Nebendiagnosen und Prozeduren richtig und vollständig dokumentiert werden. Auch der finanzielle Mehrwert eines interdisziplinären Eingriffs lässt sich durch die Erhöhung des Erlöses mit mikrochirurgischem Operationsanteil errechnen.Zwischen den Kliniken eines Krankenhauses sollte daher eine interdisziplinäre Erlösaufteilung stattfinden. Für eine faire und transparente interdisziplinäre Leistungsverrechnung existieren mehrere Modelle, mit denen alle beteiligten Kliniken einen Mehrwert erwirtschaften können. Leider bestehen an vielen Krankenhäusern unzureichende interdisziplinäre Vergütungsmodelle, welche eine qualitativ hochwertige, kostendeckende Patientenversorgung mit mikrochirurgischen Eingriffen erschweren. Ungeachtet des zunehmenden Kostendrucks und nicht medizinischer wirtschaftlicher Aspekte muss unser Handeln als Arzt immer die bestmögliche Patientenversorgung sicherstellen.

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Autologous versus implant-based breast reconstruction: A systematic review and meta-analysis of Breast-Q patient-reported outcomes

Cited by 155 publications

References 32 publications

Management of patients with BRCA mutation from the point of view of a breast surgeon

Management of patients with BRCA mutation from the point of view of a breast surgeon

Population‐based picture of breast reconstruction in Queensland, Australia

Wirtschaftliche Aspekte in der Mikrochirurgie: Bericht zum Konsensus-Workshop der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße – (DAM)

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Autologous versus implant-based breast reconstruction: A systematic review and meta-analysis of Breast-Q patient-reported outcomes

Cited by 155 publications

References 32 publications

Management of patients with BRCA mutation from the point of view of a breast surgeon

Management of patients with BRCA mutation from the point of view of a breast surgeon

Population‐based picture of breast reconstruction in Queensland, Australia

﻿Wirtschaftliche Aspekte in der Mikrochirurgie: Bericht zum Konsensus-Workshop der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße – (DAM)

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Wirtschaftliche Aspekte in der Mikrochirurgie: Bericht zum Konsensus-Workshop der Deutschsprachigen Arbeitsgemeinschaft für Mikrochirurgie der peripheren Nerven und Gefäße – (DAM)