Skip to main content

Advertisement

SpringerLink
Log in

Analysis of outcomes and patient’s satisfaction following monolateral and bilateral mastectomy using BREAST-Q

  • Original Paper
  • Published:
European Journal of Plastic Surgery Aims and scope Submit manuscript

Abstract

Background

Breast reconstruction plays an important role in improving the quality of life of patients with breast cancer. The aim of this study is to verify if there is a difference in patient’s satisfaction and in body perception following monolateral and bilateral mastectomy with breast reconstruction.

Methods

The study population were 144 women who had undergone mastectomy and breast reconstruction at our hospital between 2005 and 2016. They filled out BREAST-Q post-operative module after almost 1 year from breast reconstruction. We administered the questionnaire electronically almost 1 year after surgery for each procedure.

Results

This cross-sectional study compared two cohorts in which 121 women underwent monolateral mastectomy and breast reconstruction with or without contralateral adjustment and 23 women underwent bilateral mastectomy and breast reconstruction. After reconstruction procedures, patients that underwent bilateral mastectomy were more satisfied than monolateral mastectomy group in satisfaction with appearance of breast (P < 0.001). In the comparison between monolateral and bilateral nipple-sparing mastectomy groups, the bilateral nipple mastectomy group was more satisfied in satisfaction with appearance of breast (P = 0.005) and physical well-being (P = 0.003). In the comparison between bilateral nipple-sparing mastectomy and no nipple-sparing mastectomy, the first group was more satisfied in psychosocial well-being (P = 0.03) and physical well-being (P = 0.03).

Conclusions

Bilateral mastectomy has a favorable post-operative surgical cosmetic outcome with a better patient’s body image perception and bigger post-operative satisfaction. This is the first study that compares monolateral and bilateral mastectomy using a validated patient-reported outcome measure.

Level of Evidence: Level III, risk/prognostic study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Chao LF, Patel KM, Chen SC et al (2014) Monitoring patient-centered outcomes through the progression of breast reconstruction: a multicentered prospective longitudinal evaluation. Breast Cancer Res Treat 146(2):299–308

    Article  Google Scholar 

  2. Duraes EF, Durand P, Duraes LC et al (2016) Comparison of preoperative quality of life in breast reconstruction, breast aesthetic and non-breast plastic surgery patients: a cross-sectional study. J Plast Reconstr Aesthet Surg 69(11):1478–1485

    Article  Google Scholar 

  3. Ly D, Forman D, Ferlay J, Brinton LA, Cook MB (2013) An international comparison of male and female breast cancer incidence rates. Int J Cancer 132(8):1918–1926

    Article  CAS  Google Scholar 

  4. Juhl AA, Christensen S, Zachariae R, Damsgaard TE (2017) Unilateral breast reconstruction after mastectomy—patient satisfaction, aesthetic outcome and quality of life. Acta Oncol 56(2):225–231

    Article  Google Scholar 

  5. Veiga DF, Sabino Neto M, Ferreira LM et al (2004) Quality of life outcomes after pedicled TRAM flap delayed breast reconstruction. Br J Plast Surg 57(3):252–257

    Article  CAS  Google Scholar 

  6. Waljee JF, ES H, Ubel PA et al (2008) Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life. J Clin Oncol 26(20):3331–3337

    Article  Google Scholar 

  7. Sacchini V, Pinotti JA, Barros AC et al (2006) Nipple-sparing mastectomy for breast cancer and risk reduction: oncologic or technical problem? J Am Coll Surg 203(5):704–714

    Article  Google Scholar 

  8. Garcia-Etienne CA, Borgen PI (2006) Update on the indications for nipple-sparing mastectomy. J Support Oncol 4(5):225–230

    PubMed  Google Scholar 

  9. Pusic AL, Klassen AF, Scott AM, Klok JA, Cordeiro PG, Cano SJ (2009) Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg 124(2):345–353

    Article  CAS  Google Scholar 

  10. Satteson ES, Brown BJ, Nahabedian MY (2017) Nipple-areolar complex reconstruction and patient satisfaction: a systematic review and meta-analysis. Gland Surg 6(1):4–13

    Article  Google Scholar 

  11. Filiberti A, Tamburini M, Murru L et al (1986) Psychologic effects and esthetic results of breast reconstruction after mastectomy. Tumori 72(6):585–588

    Article  CAS  Google Scholar 

  12. Guyomard V, Leinster S, Wilkinson M (2007) Systematic review of studies of patients’ satisfaction with breast reconstruction after mastectomy. Breast 16(6):547–567

    Article  Google Scholar 

  13. Ramon Y, Ullmann Y, Moscona R et al (1997) Aesthetic results and patient satisfaction with immediate breast reconstruction using tissue expansion: a follow-up study. Plast Reconstr Surg 99(3):686–691

    Article  CAS  Google Scholar 

  14. Shaikh-Naidu N, Preminger BA, Rogers K, Messina P, Gayle LB (2004) Determinants of aesthetic satisfaction following TRAM and implant breast reconstruction. Ann Plast Surg 52(5):465–470

    Article  Google Scholar 

  15. Nicholson RM, Leinster S, Sassoon EMA (2007) Comparison of the cosmetic and psychological outcome of breast reconstruction, breast conserving surgery and mastectomy without reconstruction. Breast 16(4):396–410

    Article  CAS  Google Scholar 

  16. Shekhawat L, Busheri L, Dixit S, Patel C, Dhar U, Koppiker C (2015) Patient-reported outcomes following breast reconstruction surgery and therapeutic mammoplasty: prospective evaluation 1 year post-surgery with BREAST-Q questionnaire. Indian J Surg Oncol 6(4):356–362

    Article  Google Scholar 

  17. Cordeiro PG, Albornoz CR, McCormick B et al (2015) What is the optimum timing of postmastectomy radiotherapy in two-stage prosthetic reconstruction: radiation to the tissue expander or permanent implant? Plast Reconstr Surg 135(6):1509–1517

    Article  CAS  Google Scholar 

  18. Howard MA, Sisco M, Yao K, Winchester DJ, Barrera E, Warner J, Jaffe J, Hulick P, Kuchta K, Pusic AL, Sener SF (2016) Patient satisfaction with nipple-sparing mastectomy: a prospective study of patient reported outcomes using the BREAST-Q. J Surg Oncol 114(4):416–422

    Article  Google Scholar 

  19. Peled AW, Duralde E, Foster RD et al (2014) Patient-reported outcomes and satisfaction after total skin-sparing mastectomy and immediate expander-implant reconstruction. Ann Plast Surg 72(Suppl 1):S48–S52

    PubMed  Google Scholar 

  20. Salgarello M, Visconti G, Barone-Adesi L (2010) Nipple-sparing mastectomy with immediate implant reconstruction: cosmetic outcomes and technical refinements. Plast Reconstr Surg 126(5):1460–1471

    Article  CAS  Google Scholar 

  21. Metcalfe KA, Cil TD, Semple JL et al (2015) Long-term psychosocial functioning in women with bilateral prophylactic mastectomy: does preservation of the nipple-areolar complex make a difference? Ann Surg Oncol 22(10):3324–3330

    Article  Google Scholar 

  22. van Verschuer VM, Mureau MA, Gopie JP et al (2016) Patient satisfaction and nipple-areola sensitivity after bilateral prophylactic mastectomy and immediate implant breast reconstruction in a high breast cancer risk population: nipple-sparing mastectomy versus skin-sparing mastectomy. Ann Plast Surg 77(2):145–152

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Unit of Plastic Surgery and Dermatology, Department of Medicine, Campus Bio-Medico University of Rome, Rome, Italy

    M. Barone, A. Cogliandro & P. Persichetti

  2. Institute of Philosophy of Scientific and Technological Practice, Campus Bio-Medico University of Rome, Rome, Italy

    V. Tambone

Authors
  1. M. Barone
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A. Cogliandro
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. V. Tambone
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. P. Persichetti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A. Cogliandro.

Ethics declarations

Conflict of interest

M. Barone, A. Cogliandro, V. Tambone, P. Persichetti declare that they have 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/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Patient consent

Patients provided written consent before their inclusion in this study. Additional consent was obtained for the use of their images.

Funding

None.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Barone, M., Cogliandro, A., Tambone, V. et al. Analysis of outcomes and patient’s satisfaction following monolateral and bilateral mastectomy using BREAST-Q. Eur J Plast Surg 41, 311–316 (2018). https://doi.org/10.1007/s00238-017-1376-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00238-017-1376-x

Keywords

Search

Navigation