Patient Satisfaction in Postmastectomy Breast Reconstruction: A Comparative Evaluation of DIEP, TRAM, Latissimus Flap, andImplant Techniques

Abstract

Autologous, abdominal-based reconstructions had the highest satisfaction rates across all four groups. After logistic regression analysis, differences in patient satisfaction between pedicle TRAM and DIEP flap reconstruction were no longer observed. Discussing satisfaction outcomes with patients will help them make educated decisions about breast reconstruction.

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

“…It has been well documented that autologous tissue reconstruction using the abdomen generates higher patient satisfaction than exclusively implant-based or combined procedures. 13,19,51,52 In addition, among the autologous tissue reconstructions, abdominally based flaps had significantly higher general satisfaction (P ¼ .011) and esthetic satisfaction (P ¼ .016) than latissimus dorsi flaps. 13 Finally, unlike implant-based or combined latissimus dorsi flap with implant reconstructions, which need first to temporize with a tissue expander followed by a second replacement surgery, the breast mound is completely created after free MS-TRAM or DIEP flap reconstruction.…”

“…13,19,51,52 In addition, among the autologous tissue reconstructions, abdominally based flaps had significantly higher general satisfaction (P ¼ .011) and esthetic satisfaction (P ¼ .016) than latissimus dorsi flaps. 13 Finally, unlike implant-based or combined latissimus dorsi flap with implant reconstructions, which need first to temporize with a tissue expander followed by a second replacement surgery, the breast mound is completely created after free MS-TRAM or DIEP flap reconstruction. Therefore, it is conceivable that patient satisfaction and Hr-QOL scores would be lower in a patient who is still undergoing the process of breast mound creation than in someone who has completed it.…”

“…In addition, because we designed this study to obtain measurements at specified time intervals after breast reconstruction (3 weeks and 3 months), this approach avoided the potential bias inherent in assessing Hr-QOL at various lengths of time after surgery. 13,[15][16][17][18][19][20][21][22][23] Although the observed improvements in Hr-QOL domains and satisfaction in breast were both statistically and clinically significant after breast reconstruction, we did not use a control group. Without comparison groups who underwent mastectomy alone or breast-conservation therapy, the gains in Hr-QOL and satisfaction attributed to breast reconstruction cannot be fully placed into context.…”

“…Although previous research has examined psychosocial outcomes among women who undergo mastectomy with and without reconstruction and breast-conservation therapy, many studies have used cross-sectional study designs, which lack baseline data for comparison and a longitudinal perspective. [4][5][6][7][8][9][10][11][12][13] samples of patients who underwent a variety of different postmastectomy breast reconstruction techniques whose outcomes evolved with various timelines.…”

Breast reconstruction and radiotherapy

“…Одномомент-ные реконструкции собственными тканями проводятся в 14% случаев [Cemal Y., 2013; Jagsi R., 2014]. Эстетиче-ски долгосрочный результат стабильнее при аутологич-ной реконструкции, чем при реконструкции импланта-том [Yueh J.H., 2010].…”