The effect of implant loss after immediate breast reconstruction on patient satisfaction with outcome and quality of life after five years – a case-control study

Figures & data

Figure 1. Patients and controls.

Table 1. Background variables and primary and secondary outcomes.

Demography/background variables	Patients (n = 16)	Controls (n = 27)	Difference between groups
	Median (max–min)	Median (max–min)
	Mean (SD)	Mean (SD)
Demography/background variables
Age at time of mastectomy and IBR (years)	44 (27–64)	48 (26–67)	NC
	44 (11)	48 (10)
Time since mastectomy and IBR (years)	5.6 (2.3–16)	4.8 (1.6–11)	NC
	5.8 (3.3)	5.3 (2.6)
Reason for operation (n)			NC
Therapeutic	8	22
Prophylactic	8	5
Time since implant loss (years)	5.5 (1.9–10)	NA	NC
	5.2 (2.3)
Reason for implant loss			NC
Necrosis	6	NA
Infection	10
Re-reconstruction			NC
Yes	14	NA
No	2
	(n = 14)	NA	NC
Time between implant loss and re-reconstruction (years)	0.6 (0.3–2.1)
	0.7 (0.5)
Type of re-reconstruction		NA	NC
Implant based	12
LD and implant	2
	(n = 14)
		(n = 26)	NC
Body image (BESAA)	60 (39–83)	62 (39–86)
Total score	61 (14)	59 (12)
Primary outcomes (Mann–Whitney’s U-test)
	(n = 14)		0.063
Satisfaction with breast (BREAST-Q)	61 (22–78)	67 (43–100)
	57 (16)	69 (14)
Satisfaction with outcome (BREAST-Q)	61 (27–86)	75 (43–100)	0.020
	58 (18)	72 (16)
Psychosocial well-being (BREAST-Q)	56 (37–100)	83 (39–100)	0.051
	66 (25)	81 (20)
		(n = 24)	0.058
Sexual well-being (BREAST-Q)	49 (26–100)	67 (0–100)
	52 (23)	63 (24)
Physical well-being (BREAST-Q)	63 (50–100)	81 (53–100)	0.005**
	67 (14)	80 (13)
Secondary outcomes (Mann–Whitney’s U-test)
Anxiety (HADS)	N	N	0.345
No cases	11	22
Possible cases	4	4
Probable cases	1	1
Depression (n) (HADS)	N	N	0.021*
No cases	13	27
Possible cases	0	0
Probable cases	3	0
Satisfaction with information (BREAST-Q)	56 (38–77)	65 (19–85)	0.263
	58 (12)	61 (16)

BESAA: Body Esteem Scale for Adults and Adolescents; HADS: Hospital Anxiety and Depression Scale; IBR: immediate breast reconstruction; LD: latissimus dorsi flap; N: number of individuals; NC: not calculated; NA: not applicable; SD: standard deviation. *= p ≤ 0.05 **= p ≤ 0.01.

Figure 2. Scatter plots patients.

Figure 3. Scatter plots controls.

Table 2. Correlations among patients (Spearman’s rank-order correlation test).

	Satisfaction with breast	Satisfaction with outcome	Psychosocial well-being	Sexual well-being	Physical well-being
Age at time of mastectomy and IBR	−0.161	−0.439	−0.046	0.286	−0.075
Time since implant loss	−0.392	−0.550*	−0.442	−0.369	−0.030
BESAA total	0.505	0.424	0.813**	0.880**	0.236
Reason for surgery (prophylactic/therapeutic)	−0.035	−0.232	−0.207	−0.272	0.082

BESAA: Body Esteem Scale for Adults and Adolescents; IBR: immediate breast reconstruction. *= p ≤ 0.05 **= p ≤ 0.01.

Table 3. Correlations among controls (Spearman’s rank-order correlation test).

	Satisfaction with breast	Satisfaction with outcome	Psychosocial well-being	Sexual well-being	Physical well-being
Age at time of mastectomy and IBR	−0.147	−0.300	−0.103	−0.248	0.132
Time since implant loss		−	−	−	−
BESAA total	0.550**	0.407*	0.392*	0.407	0.017
Reason for surgery (prophylactic/therapeutic)	−0.282	−0.156	−0.317	−0.134	−0.217

BESAA: Body Esteem Scale for Adults and Adolescents; IBR: immediate breast reconstruction. *= p ≤ 0.05 **= p ≤ 0.01.