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Breast reconstruction and quality of life five years after cancer diagnosis: VICAN French National cohort

  • Epidemiology
  • Published:
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Abstract

Purpose

Women with breast cancer (BC) who have a mastectomy may subsequently undergo breast reconstruction (BR). This study aimed to identify (1) factors associated with having BR, (2) factors associated with immediate BR (IBR) and delayed BR (DBR), and (3) associations between no BR, IBR and DBR and physical and mental quality of life (QoL) 5 years after diagnosis.

Methods

Analyses were based on data from the national French cancer cohort VICAN, which followed a representative sample of cancer survivors, including BC survivors, for 5 years after diagnosis. BR and BR type (IBR/DBR) were identified using medico-administrative databases. The SF12 scale was used to measure mental and physical QoL. Multivariate logistic regressions were used to identify factors associated with BR, and linear models to evaluate associations between BR and BR type with QoL.

Results

Of the 1192 BC survivors in VICAN, 32.6% (n = 388) had a mastectomy. Among them, 60.1% (n = 233) had BR. Of these, 38.6% (n = 90) and 61.4% (n = 143) had IBR and DBR, respectively. Compared with women who had BR, women who did not were more likely to be older and to have a lower level of health literacy. Compared with women who did not have BR, those with IBR had better mental QoL, while those who had either IBR or DBR had better physical QoL.

Conclusion

Older women and those with inadequate health literacy were less likely to have BR. This may reflect women’s preferences, inequalities in care options offered after a mastectomy, and socioeconomic barriers to accessing BR. These issues need further exploration. Furthermore, BR was associated with a better long-term physical QoL. IBR was associated with better mental QoL and should be promoted when possible.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Code availability

The codes are available from the corresponding author on reasonable request.

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Acknowledgements

We thank all the members of the VICAN group: Thomas Aparicio, Emmanuel Babin, Marie L’Hosmot, Marc-Karim Ben Diane, Dominique Bessette, Anne-Déborah Bouhnik, Philippe-Jean Bousquet, Michele Chantry, Claire Chauvet, Jacqueline Clavel, Sébastien Cortaredona, Blandine Courbière, Véronique Danguy, Sarah Dauchy, Mario Di Palma, Laetitia Huiart, Xavier Joutard, Marianick Lambert, Stéphane Legleye, Julien Mancini, Marie Préau, Jean-François Morere, Nora Moumjid-Ferdjaoui, Alain Paraponaris, Patrick Peretti- Watel, Lasserre Andréa, Frédérique Retornaze, Dominique Rey, Laetitia Rollin, Aline Sarradon, Valérie Seror, Jérôme Viguier, Nathalie Derozier, Jean-Marie Gagliolo, Catherine Thieblemont, and Patricia Verney. Our thanks also to Jude Sweeney (Milan, Italy) for the English revision and proofreading of the manuscript.

Funding

Memoli Victoria is the recipient of funding from Ligue Nationale contre le Cancer and has received funding from the Excellence Initiative of Aix-Marseille University—A*Midex, a French “Investissement d’Avenir programme” for doctoral training. At the time of the study, Lauzier Sophie was a researcher who received funding from the Fonds de recherche du Québec–Santé (Quebec Health Research Fund). The VICAN cohort study was funded by the French National Institute of Cancer (Institut National du Cancer, INCa) (Contrat de recherche et développement No. 05–2011).

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Authors and Affiliations

  1. Aix Marseille Univ, INSERM, IRD, SESSTIM, ISSPAM, Cancer Biomedicine & Society Group, Equipe Labellisée Ligue 2019, 13009, Marseille, BDR, France

    Memoli Victoria, Rey Dominique, Ben Diane Marc-Karim, Mancini Julien & Bouhnik Anne-Déborah

  2. Department of Surgery, Institut Paoli-Calmettes, Marseille, France

    Bannier Marie

  3. Santé Publique France, Paris, France

    Alleaume Caroline

  4. APHM, BIOSTIC, Hop Timone, Marseille, France

    Mancini Julien

  5. Université Laval, Québec, Canada

    Lauzier Sophie

  6. CHU de Québec-Université Laval Research Center, Québec, Canada

    Lauzier Sophie

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  1. Memoli Victoria
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  2. Bannier Marie
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  3. Rey Dominique
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Contributions

MV: Methodology, Investigation, Formal analysis, Writing—first draft, BAD: Methodology, Investigation, Formal analysis, Project administration, Supervision, RD, BM, AC, BDMK, MJ, LS, BAD: Validation, Writing—reviewing & editing, Methodology, Writing—reviewing & editing.

Corresponding author

Correspondence to Mancini Julien.

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Conflict of interest

The authors declare no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committees (VICAN5 was approved by the French Institute of Public Health (C11 63), the Advisory Committee on Information Processing in Material Research in the Field of Health (11–143), and the French Commission on Individual Data Protection and Public Liberties (911290).

Research involving human participants and/or animals

All procedures performed in the study 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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Victoria, M., Marie, B., Dominique, R. et al. Breast reconstruction and quality of life five years after cancer diagnosis: VICAN French National cohort. Breast Cancer Res Treat 194, 449–461 (2022). https://doi.org/10.1007/s10549-022-06626-z

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  • DOI: https://doi.org/10.1007/s10549-022-06626-z

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