Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction

Authors: Santosa, K.B. et al.
Source: JAMA Surg doi:10.1001/jamasurg.2018.1677
jamanetwork.com/journals/jamasurgery/article-abstract/2685263

Women who proceed with total mastectomy for surgical treatment of breast cancer are very often candidates for reconstruction. Reconstruction can be autologous (using a woman’s own tissue) or implant-based. As the number of mastectomies performed for breast cancer is rising, there are more conversations now about reconstruction. The investigators noted that there is little reliable information about long-term patient satisfaction with breast reconstruction.

Just over 2,000 women who underwent immediate postmastectomy breast reconstruction were included in this study. They completed quality of life questionnaires prior to surgery and then two years later. The questionnaires assessed each woman’s satisfaction with her breasts, psychosocial well-being, physical well-being and sexual well-being.

About 60% of the women completed the survey at two years. Compared to women who received implants, the women who underwent autologous postmastectomy reconstruction reported significantly higher satisfaction with their breasts. They also reported significantly higher psychosocial and sexual well-being.

This study provides more information to enhance the decision-making process for women who are considering postmastectomy breast reconstruction. Awareness of these outcomes can help women formulate more questions for, and have more detailed conversations with, their plastic surgeons.