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Quality of Life of Patients After Immediate or Delayed Autologous Breast Reconstruction

A Multicenter Study

Beugels, Jop, MD*; Kool, Melissa, MD; Hoekstra, Lisette T., PhD*; Heuts, Esther M., PhD; Tuinder, Stephania M. H., PhD*; van der Hulst, Rene R. W. J., PhD*; Piatkowski, Andrzej, PhD*

doi: 10.1097/SAP.0000000000001618
Breast Surgery

Introduction It is known that breast reconstruction improves quality of life (QoL) in women who underwent mastectomy. Previous studies showed that autologous immediate breast reconstruction is as safe as delayed breast reconstruction. However, there is not much known about the influence of the timing of the breast reconstruction on QoL. Therefore, this study aims to assess the effect of timing of the breast reconstruction on QoL, using the BREAST-Q questionnaire.

Methods A total of 543 patients aged 18 years or older who underwent deep inferior epigastric perforator flap reconstruction after mastectomy (for prophylactic or oncological reasons) at least 12 months ago were selected in 3 hospitals in the Netherlands and invited to complete the BREAST-Q. Mean QoL outcomes were compared between patients who underwent immediate or delayed breast reconstruction. Furthermore, QoL outcomes were compared with recently published normative data of the BREAST-Q.

Results Patients who underwent immediate reconstruction reported higher scores on satisfaction with psychosocial well-being, sexual well-being, physical well-being of the chest, and physical well-being of the abdomen. Patients who underwent delayed reconstruction reported higher scores on satisfaction with breasts, outcome, and nipples. However, after adjusting for potentially influencing factors, none of the differences were significant. Compared with the normative BREAST-Q data, both of our patient groups reported higher scores on satisfaction with breasts, psychological well-being, and sexual well-being, whereas they reported lower scores on satisfaction with physical well-being of the chest and the abdomen.

Conclusions This study suggests that patients who underwent immediate or delayed deep inferior epigastric perforator flap breast reconstruction have comparable QoL more than 1 year after surgery, irrespective of the timing of the breast reconstruction.

From the Departments of *Plastic and Reconstructive Surgery, and

Surgery, Maastricht University Medical Center, Maastricht, the Netherlands.

Received November 5, 2017, and accepted for publication, after revision July 16, 2018.

J. Beugels and M. Kool contributed equally.

Conflicts of interest and sources of funding: none declared.

Reprints: Andrzej Piatkowski, PhD, Department of Plastic and Reconstructive Surgery, Maastricht University Medical Center, P. Debyelaan 25, 6229 HX Maastricht, the Netherlands. E-mail: andrzej.piatkowskidegrzymala@mumc.nl.

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.