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Breast Cancer Research and Treatment

, Volume 146, Issue 2, pp 299–308 | Cite as

Monitoring patient-centered outcomes through the progression of breast reconstruction: a multicentered prospective longitudinal evaluation

  • Li-Fen Chao
  • Ketan M. Patel
  • Shin-Cheh Chen
  • Hung-Bun Lam
  • Chia-Yu Lin
  • Hsueh-Erh Liu
  • Ming-Huei Cheng
Preclinical study

Abstract

Studies have shown that having breast reconstruction has a positive influence on patient satisfaction and health-related quality of life (HRQoL) at the conclusion of treatment. However, no study has critically evaluated changes to these patient-reported outcomes during the process of undergoing breast reconstruction. This study was to prospectively evaluate changes to patient-centered metrics through the progression of breast reconstruction. An IRB-approved prospective, multi-institutional study was performed for all patients undergoing breast reconstruction between 2009 and 2011. The Breast-Q reconstruction questionnaire was used for evaluation of HRQoL and was administered at five intervals in the perioperative period. Longitudinal evaluation was performed to assess changes to HRQoL metrics during this perioperative interval. One hundred and ten patients were enrolled, and 100 patients (91.9 %) completed appropriate follow-up. Preoperative HRQoL scores were higher in patients electing to forgo reconstruction (P < 0.004), while postoperative HRQoL scores consistently deteriorated at multiple time points following mastectomy as compared to reconstructed patients. On subgroup analysis, results indicated lower initial HRQoL scores in delayed reconstruction (P < 0.05) as compared to immediate reconstruction. These scores did, however, merge at approximately 9 months postoperatively. Changes to HRQoL outcomes occur through progression of breast reconstruction. Within the first year of surgery, early decreases are mirrored by significant increases at later time points above baseline levels when evaluating most forms of reconstruction. Choosing against reconstruction will likely result in continued deterioration of HRQoL for patients undergoing cancer surgery, but steady improvements can be expected if delayed reconstruction is chosen.

Keywords

Breast cancer Prospective outcomes Breast reconstruction Breast-Q Quality of life 

Notes

Acknowledgments

This study was supported by the funding from Chang Gung Memorial Hospital in Taiwan (Grant CMRPF180081).

Conflict of interest

None.

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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Li-Fen Chao
    • 1
  • Ketan M. Patel
    • 2
  • Shin-Cheh Chen
    • 3
  • Hung-Bun Lam
    • 4
  • Chia-Yu Lin
    • 2
  • Hsueh-Erh Liu
    • 5
  • Ming-Huei Cheng
    • 2
  1. 1.Department of Nursing, Chronic Diseases and Health Promotion Research CenterChang Gung University of Science and TechnologyTaoyuanTaiwan
  2. 2.Division of Reconstructive Microsurgery, Department of Plastic and Reconstructive Surgery, Chang Gung Memorial Hospital, College of MedicineChang Gung UniversityKweishan, TaoyuanTaiwan
  3. 3.Department of General Surgery, Chang Gung Memorial Hospital, College of MedicineChang Gung UniversityTaoyuanTaiwan
  4. 4.Division of General Surgery, Department of SurgeryMackay Memorial HospitalTaipeiTaiwan
  5. 5.Department of NursingChang Gung UniversityTaoyuanTaiwan

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