Comparison of Patient Satisfaction Using the BREAST-Q Questionnaire in Patients Undergoing Breast-Conserving Surgery...

As breast cancer impacts patients' physical and mental well-being, treatment modalities are expected to enhance both survival rates and overall quality of life. With increasing cosmetic expectations, surgical techniques have been developed to enhance patient satisfaction while ensuring appropriate oncological principles. One such technique is mastectomy combined with implant reconstruction. Evidence-based data comparing patient satisfaction among surgical methods contribute to managing preoperative patient expectations and determining the type of surgery. This study aimed to compare the satisfaction levels of patients undergoing subcutaneous mastectomy with implant reconstruction and those receiving breast-conserving surgery using the BREAST-Q scale.

Two hundred female patients over the age of 18 who underwent either breast-conserving surgery or subcutaneous mastectomy with implant reconstruction for breast cancer, without concurrent oncoplastic procedures, were included. Patients who experienced implant loss for any reason were excluded. Postoperative patient satisfaction was evaluated using the BREAST-Q scale.

A total of 200 patients were included, with 115 undergoing breast-conserving surgery and 85 undergoing subcutaneous mastectomy with implant reconstruction. The mastectomy and implant group had a significantly higher proportion of patients under 50 years old (p = 0.001) and ideal body mass index (p = 0.024) compared to the breast-conserving surgery group. While nearly all patients in the breast-conserving surgery group (98%) received radiotherapy, approximately half of the mastectomy group received radiotherapy (p < 0.001). Breast-conserving surgery patients had significantly higher BREAST-Q scores in psychosocial well-being (p < 0.001), sexual well-being (p = 0.002), and satisfaction with breast appearance (p < 0.001) compared to the mastectomy and implant groups. No demographic or clinical factors affected breast satisfaction in the breast-conserving group, whereas smoking, radiotherapy, and chronic disease negatively impacted breast satisfaction in the mastectomy and implant groups.

Breast satisfaction subscale scores on the BREAST-Q were significantly higher in patients undergoing breast-conserving surgery compared with those undergoing subcutaneous mastectomy with implant reconstruction. Radiotherapy, smoking, and chronic disease history were associated with reduced satisfaction with breast appearance in the mastectomy and implant groups, whereas satisfaction levels in the breast-conserving surgery group were not influenced by any clinical or demographic factors.