Comparison of Patient-reported Outcomes after Implant Versus Autologous Tissue Breast Reconstruction Using the BREAST-Q

Abstract

Background:The demand for reconstructive breast procedures of various types has accelerated in recent years. Coupled with increased patient expectations, it has fostered the development of oncoplastic and reconstructive techniques in breast surgery. In the setting of postmastectomy reconstruction, patient satisfaction and quality of life are the most significant outcome variables when evaluating surgical success. The aim of this study was to evaluate the quality of life after implant breast reconstruction compared with autologous breast reconstruction.Materials and Methods:A cross-sectional study design was used. A total of 65 women who had completed postmastectomy implant-based or autologous reconstruction in the participating center were asked to complete the BREAST-Q (Reconstruction Module).Results:Data analysis demonstrated that women with autologous breast reconstruction were significantly more satisfied with their breasts (P = 0.0003) and with the overall outcome (P = 0.0001) compared with women with implant breast reconstruction. All other BREAST-Q parameters that were considered and observed were not significantly different between the 2 patient groups.Conclusions:Through statistical analysis, our results showed that patients who underwent autologous tissue reconstruction had better satisfaction with the reconstructed breast and the outcome, while both techniques appear to equally improve psychosocial well-being, sexual well-being, and chest satisfaction.

Does delayed immediate breast reconstruction lead to improved patients’ satisfaction?

“…As we found in our 6 months analysis, the 15 months data indicate that procedure type has a limited effect on psychosocial outcomes, in accordance with other studies [55]. However, several studies have shown that autologous tissue reconstruction patients, especially with an extended period of time, fare better on this measure in terms of aesthetical superiority and patient satisfaction when compared with implant reconstruction [56].…”

Skin- and Nipple-Areola-Sparing Mastectomy with Immediate Breast Reconstruction Using Transverse Rectus Abdominis Myocutaneous Flap and Silicone Implants in Breast Carcinoma Patients

“…Silicone implants were used only in young patients with a higher socioeconomic status. The study conducted by Pirro et al [10] in 2017 revealed that the silicone implants and TRAM flap techniques both appear to equally improve psychosocial well-being, sexual well-being, and chest satisfaction, and can be used for reconstruction of the breast. Our study also produced similar results; we assessed that a high rate of satisfaction with the breast, high rate of satisfaction with the outcome, and more psychological well-being were encountered in the TRAM group as compared with the implant group of patients, with a statistically significant p value < 0.001.There were also few complications in our study; these included wound infection, umbilical necrosis, and seroma.…”

“…The control group comprised of subjects in whom silicone implants were inserted, and comparison with the TRAM group was further evaluated. Assessment of the improvement in psychosocial well-being, sexual wellbeing, and chest satisfaction was performed by using the Breast-Q questionnaire, as recommended by Pirro et al [10]. Negative suction drains were used in all patients at the TRAM donor site and adjacent to the prosthetic implants ( Fig.…”

Patient‐reported outcomes of breast reconstruction in older women: Audit of a large metropolitan public/private practice in Sydney, Australia

“…This self‐selection of less clinically fit women towards implant‐based BR may underestimate the expected complications from autologous BR were they to be evenly distributed across techniques . However, the superiority of autologous BR over implant‐based techniques in terms of patient‐reported satisfaction has also been demonstrated in studies including women of younger ages . These findings should be made clear to all women considering BR.…”