Patient Satisfaction with Nipple-Sparing Mastectomy Followed by Implant-Based Breast Reconstruction in Early-Stage...

Nipple-sparing mastectomy (NSM) followed by implant-based breast reconstruction (IBR) is a widely accepted for early-stage breast cancer, supporting esthetic preservation and enhancing quality of life. The BREAST-Q is the gold standard patient-reported outcome measure PROM for evaluating satisfaction and post-operative wellbeing. This study employed the newly adapted Vietnamese BREAST-Q version 2.0, to assess patient satisfaction after NSM with IBR and explore influencing factors within a Vietnamese cohort.

A pilot linguistic validation of the BREAST-Q version 2.0 was first conducted in 20 patients from July 2021 to May 2022, demonstrating internal consistency and convergent validity. A subsequent cohort of 55 post-operative patients undergoing NSM with immediate IBR (July 2022-July 2024) participated in satisfaction assessment across eight BREAST-Q domains. Statistical significance was defined at P < .05.

The tool demonstrated acceptable internal reliability (Cronbach's α = 0.70) and strong convergent validity with objective esthetic scoring (r = 0.912; P < .001). Among 55 participants (mean age (43.2 ± 7.4 years), notable post-operative outcomes included Physical wellbeing-Back & Shoulder (62.3 ± 7.9), Physical Wellbeing-Chest (84.5 ± 18.6), Psychological Wellbeing (73.9 ± 15.7), and high Implant Satisfaction (81.9 ± 22.0). However, esthetic satisfaction declined significantly post-operatively (75.9 vs 65.8; P < .001). Patients ≥40 years reported higher psychological wellbeing (76.2 vs 66.3; P = .04). Reduced esthetic results correlated with lower overall satisfaction.

The Vietnamese BREAST-Q shows acceptable internal consistency and strong convergent validity, supporting its clinical utility. The decline in post-operative esthetic satisfaction highlights rising patient expectations, emphasizing the need for improved cosmetic outcomes and individualized care planning in Vietnam.