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

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dc.contributor.authorJeevan, Ranjeet
dc.contributor.authorBrowne, John P.
dc.contributor.authorGulliver-Clarke, Carmel
dc.contributor.authorPereira, Jerome
dc.contributor.authorCaddy, Christopher M.
dc.contributor.authorvan der Meulen, Jan H. P.
dc.contributor.authorCromwell, David A.
dc.date.accessioned2018-06-19T10:21:02Z
dc.date.available2018-06-19T10:21:02Z
dc.date.issued2017-05-01
dc.date.updated2018-06-07T10:33:38Z
dc.description.abstractBackground: 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.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationJeevan, 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.0000000000003236en
dc.identifier.doi10.1097/PRS.0000000000003236
dc.identifier.endpage1045en
dc.identifier.issn0032-1052
dc.identifier.issn1529-4242
dc.identifier.issued5en
dc.identifier.journaltitlePlastic and Reconstructive Surgeryen
dc.identifier.startpage1036en
dc.identifier.urihttps://hdl.handle.net/10468/6367
dc.identifier.volume139en
dc.language.isoenen
dc.publisherLippincott, Williams & Wilkinsen
dc.rightshttps://doi.org/10.1097/PRS.0000000000003236en
dc.subjectBreast neoplasmsen
dc.subjectBreast reconstructionen
dc.subjectOutcome measuresen
dc.subjectUnited Kingdomen
dc.subjectMastectomyen
dc.titleSurgical determinants of patient-reported outcomes following post-mastectomy reconstruction in women with breast canceren
dc.typeArticle (peer-reviewed)en
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