Quality of life after immediate breast reconstruction and skin-sparing mastectomy – A comparison with patients undergoing breast conserving surgery

Heneghan, Helen; Prichard, Ruth; Lyons, Rena; Regan, Padraic J.; Kelly, Jack L.; Malone, Carmel; McLaughlin, Ray; Sweeney, Karl; Kerin, Michael J.

doi:10.1016/j.ejso.2011.08.126

Cited by 91 publications

(57 citation statements)

References 48 publications

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“…In contrast to mastectomy, IBR has been shown to provide better cosmetic outcome and superior quality of life, without compromising oncological safety (2)(3)(4)(5)(6)(7)(9)(10)(11)(12)(13)(40)(41)(42)(43)(44).…”

Section: Discussionmentioning

confidence: 99%

“…The cosmetic outcome of IBR is superior to mastectomy (5). Literature has proven good psychosocial outcome and quality of life in patients who underwent IBR (2,4,6,7). A study conducted by Al-Ghazal et al showed that patients who underwent IBR showed less psychological distress than patients who underwent delayed breast reconstruction (8).…”

Section: Introductionmentioning

confidence: 99%

“…In 2013 approximately 14,000 patients in the Netherlands were diagnosed with breast cancer, which is almost 30% of all cancer patients in the Netherlands (1). The cornerstone of breast cancer treatment is surgery in which mastectomy is still required, or the patients preferred option, in one third of all breast cancer patients (2,3). Breast reconstruction can be performed at the time of mastectomy, immediate breast reconstruction (IBR) using autologous tissue or implants (4).…”

Section: Introductionmentioning

confidence: 99%

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Factors influencing the decision to pursue immediate breast reconstruction after mastectomy for breast cancer

et al. 2017

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Background: Immediate breast reconstruction (IBR) after mastectomy has shown to be oncologically safe and to improve quality of life in breast cancer patients. However, most women undergoing mastectomy do not undergo IBR. In this study, we aim to identify breast surgeon-related factors in considering IBR and factors affecting patients' decision to choose for IBR.Methods: Retrospective analysis of the records of breast cancer patients who underwent mastectomy with or without IBR between 2010 and 2013. We documented all information whether or not a patient underwent IBR after mastectomy.Results: Of 437 patients, 97 (22.2%) underwent IBR, 89.8% of which received tissue expanders. Patient who did not undergo IBR had a higher age (62.2 versus 51.9 years, P<0.001) and higher body mass index (BMI) (27.0 versus 24.3, P<0.001). Hundred three patients declined IBR, mainly because considering reconstruction as too much trouble. In 128 cases the breast surgeon did not offer IBR, mostly because of the predicted need for post mastectomy radiation. Approximately 11% of the patients were not informed about IBR.Conclusions: Anticipated radiation therapy, higher age and higher BMI were important breast surgeonrelated factors in refraining from IBR. Almost one third of all patients declined IBR. In almost 10% of all patients, IBR was not discussed.Keywords: Breast neoplasms; breast reconstruction; decision making; mammaplasty; mastectomy Submitted Aug 11, 2016. Accepted for publication Oct 27, 2016Oct 27, . doi: 10.21037/gs.2016 View this article at: http://dx.doi.org/10.21037/gs.2016.11.11 44 Weenk et al. Decision-making process in IBR © Gland Surgery. All rights reserved.Gland Surg 2017;6(1):43-48 gs.amegroups.com States. In 2000, 12.9% of all mastectomies performed in the United States were combined IBR, increasing to 36.3% in 2009 (15). The United Kingdom Association of Breast Surgery recommends that any patient in which IBR is oncologically safe should have the possibility to choose for IBR (16). Dutch guidelines state IBR has a slight preference instead of delayed reconstruction and that every patient considered for mastectomy has to be informed about reconstructive options (17). However, despite the evidence and recommendations, almost two thirds of the mastectomies are still performed without IBR. We asked ourselves if there are elements in the pre-operative process that could facilitate or impede the choice for IBR. The major objective of this study was to investigate the decision-making process on whether or not a patient undergoes immediate reconstruction after mastectomy. In this study we focused on the role of patient as well as the role of the breast surgeon. MethodsWe investigated all electronic patient files of women diagnosed with DCIS or invasive carcinoma between 2010 and 2013, and underwent a mastectomy at the Canisius Wilhelmina Breast Center in Nijmegen, the Netherlands. Patients who underwent prophylactic mastectomy were excluded. IBR is defined as mastectomy and reconstruction performed on the same day. ...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors influencing the decision to pursue immediate breast reconstruction after mastectomy for breast cancer

et al. 2017

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“…To achieve adequate locoregional control, approximately 40 per cent of patients have a total mastectomy2 3. For these patients, breast reconstruction is proven to improve psychosocial and aesthetic outcomes4. Recent guidelines5 6 recommend that reconstruction should be discussed and offered as an option for the majority of women undergoing mastectomy.…”

Section: Introductionmentioning

confidence: 99%

Trends in breast reconstruction practices in a specialized breast tertiary referral centre

et al. 2017

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BackgroundBreast reconstruction is an important component of multidisciplinary breast cancer management. The practice of breast reconstruction after mastectomy has evolved significantly in the past decade as a result of both increasing mastectomy rates and advances in reconstructive strategy. These changes have significantly influenced the contemporary surgical management of breast cancer. The aim of this study was to examine trends in breast reconstruction after mastectomy in an Irish population.MethodsData were reviewed from a database of all patients who had mastectomy with or without breast reconstruction at Galway University Hospital, a tertiary breast cancer referral centre, between 2004 and 2014. Trends in breast reconstruction after mastectomy were explored with respect to patient demographics, clinicopathological features, and neoadjuvant and adjuvant therapy.ResultsOf 1303 patients who underwent mastectomy during interval studied, 706 (54.2 per cent) had breast reconstruction after mastectomy. In 629 patients (89·1 per cent), breast reconstruction was performed in the immediate setting. Reconstruction rates increased over time from 20·5 per cent in 2004 to 44·7 per cent in 2014. Reconstruction was more commonly performed in younger patients and those with benign, in situ and early‐stage disease. A negative relationship between radiotherapy and reconstruction was observed. A pedicled flap with or without an implant was the most commonly used reconstructive approach in patients receiving radiotherapy.ConclusionBreast reconstruction after mastectomy has become the standard of care in the surgical treatment of breast cancer. Recent trends show a transition favouring implant‐based approaches.

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“…Muitos estudos foram realizados com mulheres em estádio I e II (He et al, 2012;Parker et al, 2007), entretanto há estudos que consideram as mulheres em estádio I, II, III (Han et al, 2010;Shi et al, 2011) e ainda estádio IV (Heneghan et al, 2011). Há também pesquisadores que não informaram o estádio das pacientes (Veiga et al, 2010).…”

Section: Variáveis Clínicasunclassified

Qualidade de vida e a cirurgia em cancro da mama: revisão narrativa da literatura

Eberhardt

Lins

2017

CES Psico

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Quality of life after immediate breast reconstruction and skin-sparing mastectomy – A comparison with patients undergoing breast conserving surgery

Abstract: IBR is a highly acceptable form of treatment for women requiring mastectomy. With high rates of patient satisfaction, low associated morbidity, and proven oncological safety, it is an appropriate recommendation for all women requiring mastectomy.

Cited by 91 publications

References 48 publications

Factors influencing the decision to pursue immediate breast reconstruction after mastectomy for breast cancer

Factors influencing the decision to pursue immediate breast reconstruction after mastectomy for breast cancer

Trends in breast reconstruction practices in a specialized breast tertiary referral centre

Qualidade de vida e a cirurgia em cancro da mama: revisão narrativa da literatura

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