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Quality of Life after Breast Reconstruction: What positively influences patient's satisfaction?
Eliana F.R. Duraes, MD1, Todd Baker MD, Megan Morisada BA, Susan Orra, BA, Joao Batista de Sousa, MD PhD2, Risal S. Djohan, MD, Steven Bernard, MD, Graham S. Schwarz, MD, Andrea Moreira, MD
Cleveland Clinic - Plastic Surgery Department
2015-03-12
Presenter: Eliana Duraes
Affidavit:
Must of this study was a work from the first author, Eliana Duraes
Director Name: Steven Bernard
Author Category: Fellow Plastic Surgery
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Implant-based breast reconstruction is by far the most frequent technique used for breast reconstruction1. This study aims to establish different factors that influence patient reported quality of life. This will help in perioperative counseling and education in the breast reconstructive population.
From 2009-2011, 820 patients who underwent any type of breast reconstruction for cancer treatment or prophylaxis received a post-operative BreastQ3. Answers were compared according to the need for radiation (RT), body mass index (BMI), bilateral (BiR) or unilateral (UnR) reconstruction, presence of nipple (NAC+), and implant-only (IBR) versus autologous reconstructions (ABR). We defined ABR as the use of lower abdomen or back tissue associated with or without an implant. NAC+ group included patients that had either the nipple reconstructed or a nipple-sparing mastectomy.
A total of 261 patients answered the questionnaires. IBR compared to ABR had lower BMI (p<0.01), more immediate (p<0.01) and prophylactic (p=0.03) cases; ABR had more RT (p<0.01). NAC+ group had a lower age (p<0.01). Satisfaction with breasts was higher in ABR, No Rt, BiR, BMI 25.9 versus >30. No RT had higher satisfaction with outcome and physical well-being. Psychosocial well-being was higher in no-RT, and BMI 25-29.9 versus >30. Sexual well-being was higher in NAC+.
Radiation therapy is related to a lower satisfaction with outcome, and lower psychosocial and physical well-being. Overall, satisfaction with breasts is higher when autologous reconstruction is used. Bilateral reconstructions, a BMI of 25-29.9 and nipple reconstruction positively influence satisfaction.
