Muscle-Sparing Skin-Reducing Breast Reconstruction with Pre-Pectoral Implants in Breast Cancer Patients: Long-Term Assessment of Patients’ Satisfaction and Quality of Life

Abstract

Introduction

Breast cancer is the most frequently diagnosed tumor in women; globally, it accounts 23% of all cancer deaths. Breast reconstruction after oncologic surgery has become crucial to enhance patients’ quality of life and alleviate the psychological distress related to the disease. The aim of this study was to assess quality of life and esthetic satisfaction of breast cancer patients undergoing muscle-sparing skin-reducing breast reconstruction (MS-SR) with pre-pectoral implants.

Methods

Sixty-three patients who met definite oncological and reconstructive criteria were enrolled in the study. Specific questionnaires (EORTC QLQ-C30, QLQ-BR23) were administered preoperatively, 1, and 12 months after MS-SR breast reconstruction to evaluate patients’ QoL. Satisfaction with procedure and related Quality of Life were assessed through BREAST-Q questionnaire preoperatively and 12 months after surgery.

Results

Sixty-three breast cancer patients underwent MS-SR. Seventy-eight procedures were carried out; in 15 patients a bilateral reconstruction was performed. One month after surgery, both EORTC QLQ-C30 and QLQ-BR23 average scores demonstrated a slight drop since preoperative values, but a significant improvement in QoL was documented 12 months after BR (p < 0.05). BREAST-Q test showed significant psychophysical and esthetic satisfaction 12 months postoperatively.

Conclusions

Muscle-sparing skin-reducing breast reconstruction is an established and reliable technique. EORTC QLQ-C30, QLQ-BR23 and BREAST-Q scores showed an improvement of patients’ QoL and esthetic satisfaction. Reduction of pain and other surgery-related symptoms are cornerstones of patient well-being. Both physicians and patients should build a thorough awareness of the silver lining of muscle-sparing skin-reducing breast reconstruction based on the high safety profile and highly satisfactory patient-reported results.

Keywords:

• Breast cancer
• breast reconstruction
• skin-reducing nipple-sparing mastectomy
• BREAST-Q
• EORTC QLQ-C30

This article is referred to by:

Prepectoral Breast Reconstruction and Quality of Life: One Step Further

To our knowledge, this is the first study that analyzed both QoL and esthetic satisfaction of patients undergoing MS-SR by administering three validated questionnaires (EORTC QLQ-C30, QLQ-BR23 and BREAST-Q). Reduction of pain and other surgery-related symptoms are cornerstones of patient well-being. We reported low complication rate and highly satisfactory patient-reported results. These data could be highly useful for both physicians and patients to build a thorough awareness about the silver lining of muscle-sparing skin-reducing breast reconstruction.

Disclosure statement

No potential conflict of interest was reported by the author(s).