Skip to main content
Erschienen in: Aesthetic Plastic Surgery 1/2023

04.08.2022 | Original Article

Direct-to-Implant Breast Reconstruction After Unilateral and Bilateral Mastectomy: Cross-Sectional Study of Patient Satisfaction and Quality of Life with BREAST-Q

verfasst von: Annalisa Cogliandro, Rosa Salzillo, Mauro Barone, Stefania Tenna, Barbara Cagli, Paolo Persichetti

Erschienen in: Aesthetic Plastic Surgery | Ausgabe 1/2023

Einloggen, um Zugang zu erhalten

Abstract

Introduction

Immediate single stage breast reconstruction is a challenging procedure with the goal of improving the quality of life of patients with breast cancer. The aim of this study is to evaluate using the BREAST-Q patient satisfaction, body perception and quality of life after direct-to-implant breast reconstruction comparing unilateral and bilateral reconstructions.

Methods

In this study we enrolled 56 women who underwent mastectomy and immediate single-stage direct-to-implant (DTI) breast reconstruction at Campus Bio-Medico University of Rome between 2013 and 2020. One year after surgery they were administered electronically the BREAST-Q post-operative module.

Results

Our two cohorts of patients consisted in 34 women who received unilateral nipple-sparing mastectomy and DTI breast reconstruction and 22 women who underwent bilateral nipple-sparing mastectomy and DTI breast reconstruction. Twenty-four of the 34 patients belonging to the unilateral group responded to the questionnaire (70.5%), while in the bilateral group responders were 16 out of 22 (72.7%). The BREAST-Q scores were compared between the two groups: patients undergoing bilateral mastectomy and breast reconstruction showed higher scores in every BREAST-Q domain compared to patients undergoing unilateral mastectomy and breast reconstruction with a statistically significant difference in the Satisfaction with breast (P = 0.01), Sexual well-being (P = 0.03), and Satisfaction with implants (P = 0.01) domains.

Conclusions

Patients undergoing bilateral DTI breast reconstruction have a favorable postoperative surgical cosmetic outcome with a better patient’s body image perception and a higher post-operative level of satisfaction compared to unilateral DTI reconstruction after nipple-sparing mastectomy.

Level of evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.​springer.​com/​00266
Literatur
3.
Zurück zum Zitat King CA, Bartholomew AJ, Sosin M, Avila A, Famiglietti AL, Dekker PK, Perez-Alvarez IM, Song DH, Fan KL, Tousimis EA (2021) A critical appraisal of late complications of prepectoral versus subpectoral breast reconstruction following nipple-sparing mastectomy. Ann Surg Oncol 28(13):9150–9158. https://doi.org/10.1245/s10434-021-10085-z (Epub 2021 Aug 12 PMID: 34386913)CrossRefPubMed King CA, Bartholomew AJ, Sosin M, Avila A, Famiglietti AL, Dekker PK, Perez-Alvarez IM, Song DH, Fan KL, Tousimis EA (2021) A critical appraisal of late complications of prepectoral versus subpectoral breast reconstruction following nipple-sparing mastectomy. Ann Surg Oncol 28(13):9150–9158. https://​doi.​org/​10.​1245/​s10434-021-10085-z (Epub 2021 Aug 12 PMID: 34386913)CrossRefPubMed
4.
Zurück zum Zitat Sgarzani R, Pasquali S, Buggi F, Tognali D, Marongiu F, Mingozzi M, Melandri D, Morselli PG (2021) Curcio a sub-muscular reconstruction after NAC sparing mastectomy: direct to implant breast reconstruction with human ADM versus tissue expander. Aesthetic Plast Surg 45(2):413–420. https://doi.org/10.1007/s00266-020-02007-3 (Epub 2020 Oct 19 PMID: 33078212)CrossRefPubMed Sgarzani R, Pasquali S, Buggi F, Tognali D, Marongiu F, Mingozzi M, Melandri D, Morselli PG (2021) Curcio a sub-muscular reconstruction after NAC sparing mastectomy: direct to implant breast reconstruction with human ADM versus tissue expander. Aesthetic Plast Surg 45(2):413–420. https://​doi.​org/​10.​1007/​s00266-020-02007-3 (Epub 2020 Oct 19 PMID: 33078212)CrossRefPubMed
10.
11.
Zurück zum Zitat Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209–249. https://doi.org/10.3322/caac.21660 (Epub 2021 Feb 4 PMID: 33538338)CrossRefPubMed Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, Bray F (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71(3):209–249. https://​doi.​org/​10.​3322/​caac.​21660 (Epub 2021 Feb 4 PMID: 33538338)CrossRefPubMed
13.
Zurück zum Zitat Wild CP, Weiderpass E, Stewart BW, editors (2020). World cancer report: cancer research for cancer prevention. Lyon, France: International agency for research on cancer. Available from: http://publications.iarc.fr/586 Wild CP, Weiderpass E, Stewart BW, editors (2020). World cancer report: cancer research for cancer prevention. Lyon, France: International agency for research on cancer. Available from: http://​publications.​iarc.​fr/​586
18.
Zurück zum Zitat Mundy LR, Homa K, Klassen AF, Pusic AL, Kerrigan CL (2017) breast cancer and reconstruction: normative data for interpreting the BREAST-Q. Plast Reconstr Surg 139(5):1046e-e1055.CrossRefPubMedPubMedCentral Mundy LR, Homa K, Klassen AF, Pusic AL, Kerrigan CL (2017) breast cancer and reconstruction: normative data for interpreting the BREAST-Q. Plast Reconstr Surg 139(5):1046e-e1055.CrossRefPubMedPubMedCentral
19.
Zurück zum Zitat Klifto KM, Aravind P, Major M et al (2020) Differences between breast cancer reconstruction and institutionally established normative data using the BREAST-Q reconstruction module: a comparative study. Plast Reconstr Surg 145(6):1371–1379CrossRefPubMed Klifto KM, Aravind P, Major M et al (2020) Differences between breast cancer reconstruction and institutionally established normative data using the BREAST-Q reconstruction module: a comparative study. Plast Reconstr Surg 145(6):1371–1379CrossRefPubMed
22.
Zurück zum Zitat Al-Ghazal SK, Sully L, Fallowfield L et al (2000) The psychological impact of immediate rather than delayed breast reconstruction. Eur J Surg Oncol 26(1):17–19CrossRefPubMed Al-Ghazal SK, Sully L, Fallowfield L et al (2000) The psychological impact of immediate rather than delayed breast reconstruction. Eur J Surg Oncol 26(1):17–19CrossRefPubMed
23.
Zurück zum Zitat D’Souza N, Darmanin G, Fedorowicz Z (2011) Immediate versus delayed reconstruction following surgery for breast cancer. Cochrane Database Syst Rev 6(7):CD008674 D’Souza N, Darmanin G, Fedorowicz Z (2011) Immediate versus delayed reconstruction following surgery for breast cancer. Cochrane Database Syst Rev 6(7):CD008674
24.
Zurück zum Zitat Dean C, Chetty U, Forrest AP (1983) Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy. Lancet 1:459–462CrossRefPubMed Dean C, Chetty U, Forrest AP (1983) Effects of immediate breast reconstruction on psychosocial morbidity after mastectomy. Lancet 1:459–462CrossRefPubMed
25.
Zurück zum Zitat Spear SL, Willey SC, Feldman ED et al (2011) Nipple-sparing mastectomy for prophylactic and therapeutic indications. Plast Reconstr Surg 128:1005–1014CrossRefPubMed Spear SL, Willey SC, Feldman ED et al (2011) Nipple-sparing mastectomy for prophylactic and therapeutic indications. Plast Reconstr Surg 128:1005–1014CrossRefPubMed
26.
Zurück zum Zitat Petit JY, Veronesi U, Rey P et al (2009) Nipple-sparing mastectomy: risk of nipple-areolar recurrences in a series of 579 cases. Breast Cancer Res Treat 114:97–101CrossRefPubMed Petit JY, Veronesi U, Rey P et al (2009) Nipple-sparing mastectomy: risk of nipple-areolar recurrences in a series of 579 cases. Breast Cancer Res Treat 114:97–101CrossRefPubMed
27.
Zurück zum Zitat Benediktsson KP, Perbeck L (2008) Survival in breast cancer after nipple-sparing subcutaneous mastectomy and immediate reconstruction with implants: a prospective trial with 13 years median follow-up in 216 patients. Eur J Surg Oncol 34:143–148CrossRefPubMed Benediktsson KP, Perbeck L (2008) Survival in breast cancer after nipple-sparing subcutaneous mastectomy and immediate reconstruction with implants: a prospective trial with 13 years median follow-up in 216 patients. Eur J Surg Oncol 34:143–148CrossRefPubMed
29.
Zurück zum Zitat Barone M, Cogliandro A, Tambone V, Persichetti P (2017) Analysis of outcomes and patient’s satisfaction following monolateral and bilateral mastectomy using BREAST-Q. Eur J Plast Surg 41(3):311–316CrossRef Barone M, Cogliandro A, Tambone V, Persichetti P (2017) Analysis of outcomes and patient’s satisfaction following monolateral and bilateral mastectomy using BREAST-Q. Eur J Plast Surg 41(3):311–316CrossRef
31.
Zurück zum Zitat Larson DL, Basir Z, Bruce T (2011) Is oncologic safety compatible with a predictably viable mastectomy skin flap? Plast Reconstr Surg 127:27–33CrossRefPubMed Larson DL, Basir Z, Bruce T (2011) Is oncologic safety compatible with a predictably viable mastectomy skin flap? Plast Reconstr Surg 127:27–33CrossRefPubMed
Metadaten
Titel
Direct-to-Implant Breast Reconstruction After Unilateral and Bilateral Mastectomy: Cross-Sectional Study of Patient Satisfaction and Quality of Life with BREAST-Q
verfasst von
Annalisa Cogliandro
Rosa Salzillo
Mauro Barone
Stefania Tenna
Barbara Cagli
Paolo Persichetti
Publikationsdatum
04.08.2022
Verlag
Springer US
Erschienen in
Aesthetic Plastic Surgery / Ausgabe 1/2023
Print ISSN: 0364-216X
Elektronische ISSN: 1432-5241
DOI
https://doi.org/10.1007/s00266-022-02986-5

Weitere Artikel der Ausgabe 1/2023

Aesthetic Plastic Surgery 1/2023 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.