Breast Cancer Patient Satisfaction with Immediate Two-stage Implant-based Breast Reconstruction

Česká verzia

Authors: O. Coufal ^1,2 ; L. Gabrielová ¹; I. Justan ¹; O. Zapletal ¹; I. Selingerová ³; P. Krsička ¹
Authors place of work: Oddělení chirurgické onkologie, Masarykův onkologický ústav, Brno ¹; Klinika komplexní onkologické péče, Masarykův onkologický ústav, Brno ²; Ústav matematiky a statistiky, Přírodovědecká fakulta MU, Brno ³
Published in the journal: Klin Onkol 2014; 27(5): 353-360
Category: Původní práce
doi: https://doi.org/10.14735/amko2014353

Summary

Background:
For most breast cancer patients in the Czech Republic, breast reconstruction is available only in a delayed manner. In the Masaryk Memorial Cancer Institute (MMCI), suitable candidates are offered immediate breast reconstruction using tissue expander with later exchange to a permanent silicone implant. The aim of this study was to assess patient satisfaction with this type of reconstruction.

Patients and Methods:
Sixty-two women who had undergone surgery at the MMCI from 2007 through 2013 were sent a simple questionnaire developed by our working team. Fifty-seven patients completed the questionnaire. The data were evaluated by description methods and statistical tests.

Results:
Patient response was 92%. The absolute majority of patients (56/57) would opt for this method again. The vast majority of patients (48/57) are generally satisfied with their reconstruction. Most women (8/14) younger than 50 years after the unilateral surgery would prefer synchronous contralateral prophylactic mastectomy and bilateral reconstruction if they could choose again. After bilateral surgery, reconstructed breasts are more often regarded as a part of the patient’s body. Dressed women rate their look substantially better than when they are undressed. As for self-esteem, these women are feeling excellent or good. Their psychosocial well-being in common situations is predominantly excellent. Their sexual well-being is significantly worse, and almost half of these women indicate occasional pain in their reconstructed breasts. The patients emphasize the need for appropriate information before the surgery.

Conclusion:
Immediate two-stage implant-based breast reconstruction is a suitable option for some breast cancer patients. With regard to the less natural cosmetic result and feeling of the implant-reconstructed breast, appropriate selection of women for this type of surgery is necessary and potential candidates must be thoroughly informed in the preoperative setting.

Key words:
mastectomy – mammaplasty – tissue expansion – breast implants – patient satisfaction – questionnaires – breast reconstruction

This work was supported by the European Regional Development Fund and the State Budget of the Czech Republic RECAMO CZ.1.05/2.1.00/03.0101 and MH CZ – DRO (MMCI, 00209805).

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.

Submitted:
10. 5. 2014

Accepted:
9. 6. 2014

Zdroje

1. Eltahir Y, Werners LL, Dreise MM et al. Quality-of-life outcomes between mastectomy alone and breast reconstruction: comparison of patient-reported BREAST-Q and other health-related quality-of-life measures. Plast Reconstr Surg 2013; 132(2): 201e– 209e. doi: 10.1097/ PRS.0b013e31829586a7.

2. King TA, Borgen PI (eds). Atlas of procedures in breast cancer surgery. CRC Press 2005.

3. Cordeiro PG, McCarthy CM. A single surgeon‘s 12-year experience with tissue expander/ implant breast reconstruction: part II. An analysis of long-term complications, aesthetic outcomes, and patient satisfaction. Plast Reconstr Surg 2006; 118(4): 832– 839.

4. Coufal O, Justan I, Gabrielová L et al. Okamžité rekonstrukce prsu u onkologických pacientek – naše zkušenosti. Prakt Gyn. In press 2014.

5. Shaikh-Naidu N, Preminger BA, Rogers K et al. Determinants of aesthetic satisfaction following TRAM and implant breast reconstruction. Ann Plast Surg 2004; 52(5): 465– 470.

6. Hu ES, Pusic AL, Waljee JF et al. Patient-reported aesthetic satisfaction with breast reconstruction during the long-term survivorship period. Plast Reconstr Surg 2009; 124(1): 1– 8. doi: 10.1097/ PRS.0b013e3181ab10b2.

7. Yueh JH, Slavin SA, Adesiyun T et al. Patient satisfaction in postmastectomy breast reconstruction: a comparative evaluation of DIEP, TRAM, latissimus flap, and implant techniques. Plast Reconstr Surg 2010; 125(6): 1585– 1595. doi: 10.1097/ PRS.0b013e3181cb6351.

8. Colakoglu S, Khansa I, Curtis MS et al. Impact of complications on patient satisfaction in breast reconstruction. Plast Reconstr Surg 2011; 127(4): 1428– 1436. doi: 10.1097/ PRS.0b013e318208d0d4.

9. Růžičková J, Coufal O. Okamžitá rekonstrukce prsu a radioterapie. Klin Onkol 2008; 21(4): 154– 159.

10. Potter S, Brigic A, Whiting PF et al. Reporting clinical outcomes of breast reconstruction: a systematic review. J Natl Cancer Inst 2011; 103(1): 31– 46. doi: 10.1093/ jnci/ djq438.

11. Lemaine V, McCarthy C. Measuring outcomes in breast surgery. Clin Plast Surg 2013; 40(2): 331– 339. doi: 10.1016/ j.cps.2012.12.003.

12. Pusic AL, Klassen AF, Scott AM et al. Development of a new patient-reported outctome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 2009; 124(2): 345– 353. doi: 10.1097/ PRS.0b013e3181aee807.

13. Klassen AF, Pusic AL, Scott A et al. Satisfaction and quality of life in women who undergo breast surgery: a qualitative study. BMC Womens Health 2009; 9: 11. doi: 10.1186/ 1472-6874-9-11.

14. Guyomard V, Leinster S, Wilkinson M. Systematic review of studies of patients satisfaction with breast reconstruction after mastectomy. Breast 2007; 16(6): 547– 567.

15. Craft RO, Colakoglu S, Curtis MS et al. Patient satisfaction in unilateral and bilateral breast reconstruction. Plast Reconstr Surg 2011; 127(4): 1417– 1424.

16. Henderson JR, Tao A, Kirwan CC et al. Immediate breast reconstruction does not increase postmastectomy pain. Ann Surg Oncol 2014; 21(1): 113– 117.

17. Peled AW, Duralde E, Foster RD et al. Patient-reported outcomes and satisfaction after total skin-sparing mastectomy and immediate expander-implant reconstruction. Ann Plast Surg 2014; 72 (Suppl 1): S76– S80.

18. Buck DW 2nd, Shenag D, Heyer K et al. Patient-subjective cosmetic outcomes following the varying stages of tissue expander breast reconstruction: the importance of completion. Breast 2010; 19(6): 521– 526. doi: 10.1016/ j.breast.2010.05.017.

19. Cordeiro PG, Pusic AL, Disa JJ et al. Irradiation after immediate tissue expander/ implant breast reconstruction: outcomes, complications, aesthetic results, and satisfaction among 156 patients. Plast Reconstr Surg 2004; 113(3): 877– 881.

20. McCarthy CM, Pusic AL, Disa JJ et al. Unilateral postoperative chest wall radiotherapy in bilateral tissue expander/ implant reconstruction patients: a prospective outcomes analysis. Plast Reconstr Surg 2005; 116(6): 1642– 1647.

21. Albornoz CR, Matros E, McCarthy CM et al. Implant breast reconstruction and radiation: a multicenter analysis of long-term health-related quality of life and satisfaction. Ann Surg Oncol 2014; 21(7): 2159– 2164. doi: 10.1245/ s10434-014-3483-2.

22. Snell L, McCarthy C, Klassen A et al. Clarifying the expectations of patients undergoing implant breast reconstruction: a qualitative study. Plast Reconstr Surg 2010; 126(6): 1825– 1830. doi: 10.1097/ PRS.0b013e3181f44580.

23. Saulis AS, Mustoe TA, Fine NA. A retrospective analysis of patient satisfaction with immediate postmastectomy breast reconstruction: comparison of three common procedures. Plast Reconstr Surg 2007; 119(6): 1669– 1676.