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Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction
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Comparative UK Cross-sectional Study of Breast Cancer Patient-Reported Outcomes for Breast-Conserving Surgery and
Benjamin G Baker1, Sarah Chadwick1, Naomi Patel1
1Department of Plastic Surgery, Manchester University NHS Foundation Trust, Manchester, UK.
Summary
Breast-conserving surgery (BCS) patient satisfaction scores were comparable to free flap reconstruction (FFR) but higher than immediate implant-based reconstruction (IBR). This study highlights patient-reported outcomes in breast cancer treatment options.
Area of Science:
- Oncology
- Plastic Surgery
- Patient-Reported Outcomes
Background:
- Breast-conserving surgery (BCS) with adjuvant radiotherapy is oncologically equivalent to mastectomy with immediate breast reconstruction (IBR).
- Patient-reported outcomes are crucial for evaluating the overall success of breast cancer treatment modalities.
- Immediate breast reconstruction encompasses both implant-based (IBR) and free flap reconstruction (FFR) techniques.
Purpose of the Study:
- To compare patient-reported satisfaction with breasts following breast-conserving surgery (BCS) versus immediate breast reconstruction (IBR) and free flap reconstruction (FFR).
- To assess the impact of different surgical approaches on patient outcomes using validated instruments.
- To contribute data to an international collaboration on breast cancer treatment outcomes.
Main Methods:
- A cross-sectional study involving 271 consecutive patients undergoing unilateral BCS, IBR, or FFR.
- Validated BREAST-Q™ 'satisfaction with breasts' modules were administered six months post-surgery.
- Risk adjustment data including age, BMI, smoking, radiotherapy, and tumour burden were collected.
Main Results:
- A total of 190 women completed the questionnaires (70% response rate).
- Breast-conserving surgery (BCS) scores (mean 68) were significantly higher than immediate implant-based reconstruction (IBR) (mean 61, p=0.03) but equivalent to free flap reconstruction (FFR) (mean 66, p=0.33).
- No significant difference in satisfaction scores was found between IBR and FFR (p=0.77).
Conclusions:
- Patient satisfaction with breasts was comparable between BCS and FFR.
- Immediate implant-based reconstruction (IBR) resulted in significantly lower patient satisfaction scores compared to BCS.
- This study provides valuable insights into patient-reported outcomes for different breast cancer surgical treatments.
