Unilateral breast reconstruction after mastectomy – patient satisfaction, aesthetic outcome and quality of life

Abstract

Background: An increasing number of women undergo a breast reconstruction (BR) after treatment for breast cancer. The aim of the present study was to evaluate patient-reported esthetic satisfaction, quality of life (QoL), and the association between these, following different types of BR.

Materials and methods: All women who underwent unilateral BR in Central Denmark Region between January 2005 and July 2011 were included. Participants were sent a questionnaire package, which included the Body Image Scale, The Beck Depression Inventory, the Impact of Event Scale, and a study-specific patient-reported esthetic satisfaction scale. Additionally, patients were asked if they experienced a change in QoL owing to the BR. Based on reconstructive method and timing, participants were divided into four groups, three delayed: an abdominal flap group, a latissimus dorsi flap group, an implant ± thoracodorsal flap group; and one immediate BR group.

Results: Of 166 eligible participants, a total of 144 women (87%) completed the questionnaire. The mean follow-up was 3.8 years. Esthetic satisfaction differed significantly between groups [F(3,139) = 8.55; p < 0.001], with abdominal flap recipients reporting the highest levels of esthetic satisfaction. No between-group differences were observed for the remaining psychosocial measures. Higher satisfaction with esthetic outcome was associated with reporting higher QoL owing to the BR (odds ratio 1.10, p<0.001; 95% CI 1.06–1.15).

Conclusions: Abdominal flap recipients expressed higher satisfaction with their esthetic outcome, compared to the remaining BR types. Higher esthetic satisfaction was strongly associated with reporting an experience of higher QoL.

Acknowledgments

The authors wish to express their gratitude to the participating patients.

Disclosure statement

The authors have no conflict of interest to declare.

Ethical approval

The Central Denmark Regional Ethics board under the Danish National Committee on Biomedical Research Ethics, assessed the specific study and deemed it as exempt from need of approval and accepted to be carried out (Req. Nr. 217/2011).

Additional information

Funding

The study was funded by the Faculty of Health Sciences, Aarhus University and ‘Direktør Jacob Madsen & Hustru Olga Madsens Fond’. The financial contributors did not have any involvement in the study.