Psychosocial Aspects of Immediate versus Delayed Breast Reconstruction

Heimes, Anne‐Sophie; Stewen, Kathrin; Hasenburg, Annette

doi:10.1159/000485234

Cited by 51 publications

(40 citation statements)

References 17 publications

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“…Previous research has sustained the important role of breast reconstruction after breast cancer mastectomy . However, recent studies suggested that quality of life improvements after this procedure are not as expected since, for some patients, quality of life after breast reconstruction was unchanged, worse, or similar to the quality of life of women with mastectomy alone …”

Section: Introductionmentioning

confidence: 99%

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: Introductionmentioning

confidence: 99%

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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“…Breast reconstruction after mastectomy has a positive impact on patients' psychosocial and sexual wellbeing. Moreover, immediate breast reconstruction can provide patients with the opportunity to reduce one additional surgery and costs instead of undergoing two separate procedures [1][2][3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Does Chemotherapy or Radiotherapy Affect for Postoperative Complication in Patients Who Underwent Immediate Breast Reconstruction With Tissue Expander?

Jung

Jeon

Woo

et al. 2020

Preprint

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Background: Immediate breast reconstruction with tissue expander in patients who were expected to receive adjuvant therapy, such as chemotherapy or radiotherapy, has been a topic of debate. Postoperative complications from tissue expander procedures can delay the timing of adjuvant treatment and subsequently increase the probability of recurrence. The purpose of this study was to identify the impact of chemotherapy and radiotherapy on postoperative complications in patients who underwent immediate reconstruction (IR) using tissue expander.Method: We conducted a retrospective study of 1,081 breast cancer patients who underwent mastectomy and IR using tissue expander insertion between 2012 and 2017 in Samsung Medical Center. The patients were divided into two groups based on complications (complication group vs. no complication group). The complication group had 59 patients (5.5%) and the no complication group had 1,022 patients (94.5%). Results: In univariate analysis, lymphovascular invasion (LVI), pathologic N stage, pathologic prognostic stage, axillary lymph node dissection (ALND), adjuvant radiotherapy, and adjuvant chemotherapy were significantly associated with postoperative complications. In multivariate analysis, however, higher pathologic N stage was significantly associated with postoperative complications. Chemotherapy or radiotherapy were not risk factors for postoperative complications.Conclusions: IR with tissue expander after mastectomy may be a treatment option even when the patients are expected to receive adjuvant chemotherapy or radiotherapy. These results will aid preoperative counseling to patients who are concerned about the complications of IR caused by chemotherapy or radiotherapy.

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“…Various studies [9][10][11][12][13] have shown that immediate autologous breast reconstruction (IABR), including autologous fat grafting and myocutaneous ap transfer, is an alternative method for some patients who received BCS, with better aesthetic results and safety, lower rates of surgical complications, and higher overall survival rates compared with traditional BCS or implant-based reconstruction. Additionally, IABR has other advantages over delayed reconstruction such as a shorter total operative time, less scarring, and decreased psychological distress for the patients [14,15].…”

Section: Introductionmentioning

confidence: 99%

Short-term Outcomes and Safety of Radiotherapy for Immediate Breast Reconstruction with Autologous Flap Transfer Following Breast-conserving Surgery

Zhang

Song

Wang

et al. 2020

Preprint

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Background: The outcomes of immediate autologous breast reconstruction (IABR) after partial mastectomy followed by postoperative radiotherapy (RT) in terms of aesthetics, treatment-related complications, and local control are unclear. In this study, we evaluated the efficacy of IABR after partial mastectomy with or without breast RT, and thus the impact of radiation on autologous flap transfer.Method: A retrospective cohort study involving consecutive breast cancer patients who underwent IABR after partial mastectomy between July 2011 and December 2017 at Shengjing Hospital was performed. Patients were divided into two groups based on whether or not they received RT after IABR. We compared aesthetic outcomes and changes in the flap size over the three-dimensional coordinates at various timepoints (pre-RT, 1, 6, and 12 months post-RT), as well as postoperative complications, survival, and recurrence rates between the two groups. Results: No significant difference was found in the rate of regional recurrence between the two groups (3.13% vs. 3.85%, P=1.00), and no local recurrences occurred in either group. At the timepoints pre-RT, 1, and 6 months post-RT (approximately 4, 7, and 12 months after IABR, respectively), 77 (91.7%), 70 (83.3%), and 83 (98.8%) patients, respectively, had achieved very good or good cosmetic outcomes, and only changes in breast skin color at 1 month after RT (7 months after IABR) significantly differed between the RT and non-RT groups, with very good or good cosmetic result rates of 62.5% vs. 96.2%, respectively (P<0.001). No significant difference in the reduction of flap size was observed at any timepoint between the RT and non-RT groups. The flap size was significantly reduced at 4 months after IABR compared with the initial size during surgery, and then tended to be stable in both groups. There were no significant differences between the two groups in the rates of postoperative complications including necrosis of the flap, infection, hematoma, or seroma (all P>0.05). Finally, no grade 3 or greater RT-associated adverse events occurred during or after RT.Conclusion: RT following IABR provides aesthetically satisfactory results without intolerable adverse complications and may safely be performed in patients who underwent IABR after partial mastectomy.

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Psychosocial Aspects of Immediate versus Delayed Breast Reconstruction

Cited by 51 publications

References 17 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

Does Chemotherapy or Radiotherapy Affect for Postoperative Complication in Patients Who Underwent Immediate Breast Reconstruction With Tissue Expander?

Short-term Outcomes and Safety of Radiotherapy for Immediate Breast Reconstruction with Autologous Flap Transfer Following Breast-conserving Surgery

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