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The Impact of Obesity on Patient-Reported Outcomes Following Autologous Breast Reconstruction

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Obesity is a significant public health concern and clear risk factor for complications following breast reconstruction. To date, few have assessed patient-reported outcomes (PROs) focused on this key determinant.

Objective

Our study aimed to investigate the impact of obesity (body mass index ≥ 30) on postoperative satisfaction and physical function utilizing the BREAST-Q in a cohort of autologous breast reconstruction patients.

Methods

An Institutional Review Board-approved prospective investigation was conducted to evaluate PROs in patients undergoing autologous breast reconstruction from 2009 to 2017 at a tertiary academic medical center. The BREAST-Q reconstruction module was used to assess outcomes between cohorts preoperatively and at 6 months, 1 year, 2 years, and 3 years after reconstruction.

Results

Overall, 404 patients underwent autologous breast reconstruction with abdominal free-tissue transfer (244 non-obese, 160 obese) and completed the BREAST-Q. Although obese patients demonstrated lower satisfaction with breasts preoperatively (p = 0.04), no significant differences were noted postoperatively (p = 0.58). However, physical well-being of the abdomen was lower in the obese cohort compared with their non-obese counterparts at long-term follow-up (3 years; p = 0.04).

Conclusion

Obesity significantly impacts autologous breast reconstruction patients. Although obese patients are more likely to present with dissatisfaction with breasts preoperatively, they exhibit comparable PROs overall compared with their non-obese counterparts, despite increased complications.

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Funding

This research was funded in part through the NIH/NCI Cancer Center Support Grant P30 CA008748.

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Author notes

  1. Jonas A. Nelson and Nikhil Sobti contributed equally to this manuscript and should be considered co-first authors.

Authors and Affiliations

  1. Section of Plastic and Reconstructive Surgery Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jonas A. Nelson MD, Nikhil Sobti BA, Aadit Patel MD, Evan Matros MD, MPH, MHS, Colleen M. McCarthy MD, Joseph H. Dayan MD, Joseph J. Disa MD, Peter G. Cordeiro MD, Babak J. Mehrara MD & Robert J. Allen Jr. MD

  2. Division of Plastic and Reconstructive Surgery, Brigham and Womens Hospital, Boston, MA, USA

    Andrea L. Pusic MD, MHS

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  1. Jonas A. Nelson MD
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Corresponding author

Correspondence to Jonas A. Nelson MD.

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Disclosure

Dr. Pusic is a co-developer of the BREAST-Q, which is owned by Memorial Sloan Kettering Cancer Center. She receives a portion of the licensing fees (royalty payments) when BREAST-Q is used in industry-sponsored clinical trials. Dr. Joseph Dayan is a consultant for Stryker, and owns shares in Atea Pharmaceutical. Jonas A. Nelson, Nikhil Sobti, Aadit Patel, Evan Matros, Colleen M. McCarthy, Joseph J. Disa, Peter G. Cordeiro, Babak J. Mehrara, and Robert J. Allen Jr declare no conflicts of interest. Dr. Monica Morrow has received honoraria from Genomic Health and Roche.

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Nelson, J.A., Sobti, N., Patel, A. et al. The Impact of Obesity on Patient-Reported Outcomes Following Autologous Breast Reconstruction. Ann Surg Oncol 27, 1877–1888 (2020). https://doi.org/10.1245/s10434-019-08073-5

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  • DOI: https://doi.org/10.1245/s10434-019-08073-5

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