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Quality of life in breast cancer patients and surgical results of immediate tissue expander/implant-based breast reconstruction after mastectomy

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Objectives

The purpose of this study was to analyze the effects of prior radiotherapy (RT) as well as postmastectomy radiotherapy (PMRT) on patient-reported quality of life (QoL) and on surgical/aesthetic outcomes in patients with expander-/implant-based delayed immediate reconstruction (EIBR) compared to patients that underwent EIBR without any RT.

Material and methods

QoL was assessed by BREAST-Q, the surgical/aesthetic outcome by a structured examination and a picture analysis (BCCT.CORE software) and subsequently compared between the three cohorts.

Results

Of 161 eligible patients, 97 followed the invitation (no RT n = 54, 9 of them with bilateral EIBR; PMRT n = 26; history of RT n = 15). The surgical/aesthetic results were better in the RT-naive cohort than in the PMRT cohort, but satisfaction with outcome and psychosocial well-being were better in the PMRT cohort. The RT-naive cohort showed (significantly) higher scores in satisfaction with breast, satisfaction with implant and sexual well-being compared to the history of RT cohort, although satisfaction with outcome was comparable. The PMRT cohort reached significantly more points in almost all categories and better BCCT.CORE and examination results than the history of RT cohort. Of all patients, 92.7%, 84.6% and 78.6% (RT naive, PMRT, history of RT) would agree to undergo EIBR again.

Conclusion

EIBR results in acceptable QoL and surgical results. In patients with a prior RT, QoL is significantly lower and surgical results are significantly worse. However, high acceptance rates suggest EIBR being a justifiable option even for this group. Prospective studies and long-term follow-up are required for definitive conclusions.

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Authors and Affiliations

  1. Department of Gynecology, Red Cross Hospital Munich, Taxisstr. 3, 80637, Munich, Germany

    Moritz Hamann, Melanie Brunnbauer, Ulrich Hamann, Michael Braun & Martin Pölcher

  2. Department of Radiation Oncology, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany

    Heike Scheithauer

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Contributions

All authors participated in collecting the patient data and analyzed and interpreted the patient data. MB and MH were responsible for the outline of the research and data interpretation. MH and MP were the major contributors in writing the manuscript. All authors read and approved the final manuscript.

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Correspondence to Moritz Hamann.

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Conflict of interest

Author M. Hamann declares that he has no conflict of interest. Author M. Brunnbauer declares that she has no conflict of interest. Author H. Scheithauer declares that she has no conflict of interest. Author U. Hamann declares that he has no conflict of interest. Author M. Braun declares that he has no conflict of interest. Author M. Pölcher declares that he has no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Hamann, M., Brunnbauer, M., Scheithauer, H. et al. Quality of life in breast cancer patients and surgical results of immediate tissue expander/implant-based breast reconstruction after mastectomy. Arch Gynecol Obstet 300, 409–420 (2019). https://doi.org/10.1007/s00404-019-05201-0

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