Surgical determinants of patient-reported outcomes following post-mastectomy reconstruction in women with breast cancer

Show simple item record Jeevan, Ranjeet Browne, John P. Gulliver-Clarke, Carmel Pereira, Jerome Caddy, Christopher M. van der Meulen, Jan H. P. Cromwell, David A. 2018-06-19T10:21:02Z 2018-06-19T10:21:02Z 2017-05-01
dc.identifier.citation Jeevan, R., Browne, J. P., Gulliver-Clarke, C., Pereira, J., Caddy, C. M., van der Meulen, J. H. P. and Cromwell, D. A. (2017) 'Surgical determinants of patient-reported outcomes following post-mastectomy reconstruction in women with breast cancer', Plastic and Reconstructive Surgery, 139(5), pp. 1036-1045. doi:10.1097/PRS.0000000000003236 en
dc.identifier.volume 139 en
dc.identifier.issued 5 en
dc.identifier.startpage 1036 en
dc.identifier.endpage 1045 en
dc.identifier.issn 0032-1052
dc.identifier.issn 1529-4242
dc.identifier.doi 10.1097/PRS.0000000000003236
dc.description.abstract Background: This national prospective cohort study compared the patient-reported outcomes of breast cancer patients undergoing postmastectomy autologous reconstruction to those who had breast implants, in terms of aesthetic appearance; levels of psychological, physical, and sexual well-being; and overall satisfaction. Methods: Of 5063 women who underwent immediate reconstruction (n = 3349) or delayed reconstruction (n = 1714) between January 1, 2008, and March 31, 2009, in England, 2923 women who gave informed consent were sent validated, procedure-specific, 18-month follow-up questionnaires. Outcome scale scores ranged from 0 (poor) to 100 (excellent); multiple linear regression was used to adjust scores for patient and treatment characteristics. Results: Two thousand two hundred eighty-nine women (78 percent) returned completed questionnaires (immediate reconstruction, n = 1528; delayed reconstruction, n = 761). For immediate reconstruction, mean overall satisfaction scores for the various techniques ranged from 67 to 85 (median, 67 to 93). For delayed reconstruction, mean overall satisfaction scores ranged from 70 to 85 (median, 75 to 100). For both groups, similar gradients were observed for the other outcome scales across techniques. Reconstruction using patients’ own tissues tended to have higher mean adjusted scores compared with those techniques using implants alone (p < 0.0001 for aesthetic appearance, psychological well-being, sexual well-being, and satisfaction with outcomes for immediate and delayed reconstruction groups). Conclusions: Women who underwent autologous reconstruction tended to report greater satisfaction than those who underwent implant reconstruction. These results can inform patients of the anticipated outcomes of their selected surgery, but further research is required to confirm whether autologous reconstruction is superior in general. en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher Lippincott, Williams & Wilkins en
dc.rights en
dc.subject Breast neoplasms en
dc.subject Breast reconstruction en
dc.subject Outcome measures en
dc.subject United Kingdom en
dc.subject Mastectomy en
dc.title Surgical determinants of patient-reported outcomes following post-mastectomy reconstruction in women with breast cancer en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother John Patrick Browne, Public Health, University College Cork, Cork, Ireland. +353-21-490-3000 Email: en
dc.internal.availability Full text available en 2018-06-07T10:33:38Z
dc.description.version Accepted Version en
dc.internal.rssid 393343953
dc.description.status Peer reviewed en
dc.identifier.journaltitle Plastic and Reconstructive Surgery en
dc.internal.copyrightchecked Yes en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress en

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