The association between complications and quality of life after mastectomy and breast reconstruction for breast cancer

Browne, John; Jeevan, Ranjeet; Gulliver-Clarke, Carmel; Pereira, Jerome; Caddy, Christopher M.; Meulen, Jan van der

doi:10.1002/cncr.30788

Cited by 69 publications

(55 citation statements)

References 12 publications

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“…Nine studies out of 20 (45%) reported results favoring autologous procedures for psychosocial and sexual well‐being . Some studies also differentiated between different types of autologous procedures, favoring DIEP flaps over TRAM for psychosocial and physical well‐being on the abdomen .…”

Section: Resultsmentioning

confidence: 99%

“…Lastly, four studies out of 11 (36%) suggested that complications had a significant impact on physical, emotional, and sexual well‐being . Menez et al reported that major complications (vs minor) were associated with lower psychosocial, emotional, and sexual well‐being, while Winters et al found that early complications (vs later) were associated with lower overall quality of life.…”

Section: Resultsmentioning

confidence: 99%

“…14,26,32,34,38,39 Studies that identified between group differences also reported mixed findings. On one hand, two studies reported the benefits of a delayed procedure for emotional, 40 psychosocial, sexual, and physical wellbeing, 30 while, on the other hand, three studies reported the benefits of an immediate breast reconstruction for physical, sexual, and emotional well-being. [41][42][43] Nine studies out of 20 (45%) reported results favoring autologous procedures for psychosocial and sexual well-being.…”

Section: Surgical-related Variablesmentioning

confidence: 99%

“…[41][42][43] Nine studies out of 20 (45%) reported results favoring autologous procedures for psychosocial and sexual well-being. 5,12,15,30,37,40,[43][44][45] Some studies also differentiated between different types of autologous procedures, favoring DIEP flaps over TRAM for psychosocial and physical well-being on the abdomen. 42,45 No significant differences were found between patients who underwent TRAM or latissimus dorsi flap.…”

Section: Surgical-related Variablesmentioning

confidence: 99%

“…Lastly, four studies out of 11 (36%) suggested that complications had a significant impact on physical, emotional, and sexual wellbeing. 6,15,40,41 Menez et al 41…”

Section: Surgical-related Variablesmentioning

confidence: 99%

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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: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Surgical-related Variablesmentioning

confidence: 99%

Section: Surgical-related Variablesmentioning

confidence: 99%

“…Lastly, four studies out of 11 (36%) suggested that complications had a significant impact on physical, emotional, and sexual wellbeing. 6,15,40,41 Menez et al 41…”

Section: Surgical-related Variablesmentioning

confidence: 99%

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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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Experiences of implant loss after immediate implant-based breast reconstruction: qualitative study

et al. 2020

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Background: Immediate implant-based breast reconstruction (IBBR) is the most commonly performed reconstructive procedure in the UK, but almost one in ten women experience implant loss and reconstructive failure after this technique. Little is known about how implant loss impacts on patients' quality of life. The first phase of the Loss of implant Breast Reconstruction (LiBRA) study aimed to use qualitative methods to explore women's experiences of implant loss and develop recommendations to improve care.Methods: Semistructured interviews were conducted with a purposive sample of women who experienced implant loss after immediate IBBR, performed for malignancy or risk reduction across six centres. Interviews explored decision-making regarding IBBR, and experiences of implant loss and support received. Thematic analysis was used to explore the qualitative interview data. Sampling, data collection and analysis were undertaken concurrently and iteratively until data saturation was achieved.Results: Twenty-four women were interviewed; 19 had surgery for malignancy and five for risk reduction. The median time between implant loss and interview was 42 (range 22-74) months. Ten women had undergone secondary reconstruction, two were awaiting surgery, and 12 had declined further reconstruction. Three key themes were identified: the need for accurate information about the risks and benefits of IBBR; the need for more information about 'early-warning' signs of postoperative problems, to empower women to seek help; and better support following implant loss.Conclusion: Implant loss is a devastating event for many women. Better preoperative information and support, along with holistic patient-centred care when complications occur, may significantly improve the experience and outcome of care.

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Safety and donor site morbidity of the transverse musculocutaneous gracilis (TMG) flap in autologous breast reconstruction—A systematic review and meta‐analysis

Siegwart

Bolbos

Tapking

et al. 2021

Journal of Surgical Oncology

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Background and Objectives The transverse musculocutaneous gracilis (TMG) flap has gained popularity for breast reconstruction. However, the literature regarding its donor site morbidity is heterogeneous. This systematic review sought to clarify the evidence on donor site morbidity. Methods A systematic literature search was conducted. We included all articles reporting on donor‐site morbidity of the TMG flap for breast reconstruction. The results were analyzed in R and its extension meta. A generalized linear mixed model was used to combine proportions and their 95% confidence intervals (CIs) in a random‐effects meta‐analysis. Results Nineteen articles provided an overall sample of 843 TMG flaps. The total flap loss was low at 2% (95% CI, 1%–3%). All patients were normal weight (pooled body mass index 22.75, 95% CI, 21.88–23.63). The incidence of wound dehiscence (8%, 95% CI, 4%–16%), seroma (4%, 95% CI, 2%–7%), hematoma (2%, 95% CI, 1%–4%) and infection (0%–5%) on the TMG donor site was low. Functional impairments included sensory disturbance (0%–74%), motoric deficits (0%–50%), and changes in the genital region (0%–24%), all of which were modest. Conclusions This review confirms the safety and low donor site morbidity of the TMG flap in normal‐weight patients, which is comparable to that of other popular free flaps in breast reconstruction.

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The association between complications and quality of life after mastectomy and breast reconstruction for breast cancer

Abstract: There is a strong case for prospectively collecting flap-complication rates at the surgeon and surgical unit level and for allowing patients to access these data when they make choices about their breast cancer surgery. Cancer 2017;123:3460-7. © 2017 American Cancer Society.

Cited by 69 publications

References 12 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

Experiences of implant loss after immediate implant-based breast reconstruction: qualitative study

Safety and donor site morbidity of the transverse musculocutaneous gracilis (TMG) flap in autologous breast reconstruction—A systematic review and meta‐analysis

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