The findings appear in the January issue of Plastic and Reconstructive Surgery®.
The researchers used the “BREAST-Q” questionnaire to analyze patient satisfaction and quality of life after breast reconstruction. Ninety-two women completed the survey between 2006 and 2010. Forty-seven women underwent autologous reconstruction, generally using donor flaps from the abdomen to create the new breast. The remaining 45 women underwent alloplastic reconstruction with implants.
Women choosing reconstruction with their own tissues were more satisfied with the results, the study showed. Specifically, scores for satisfaction with the reconstructed breasts averaged about 75 (on a 100-point scale) after autologous reconstruction versus 65.5 for implant-based reconstruction.
Overall patient-satisfaction scores were also higher with autologous reconstruction: about 82 versus 74.5. Scores for various aspects of quality of life—including psychosocial, sexual, and physical well-being—were not significantly different between groups.
Findings May Reflect Differences Between Groups
The findings may at least partly reflect differences in the characteristics of women choosing different options for breast reconstruction, according to study author Yassir Eltahir, MD, and colleagues of University Medical Center Groningen, the Netherlands. Women choosing autologous reconstruction were older: 51 versus 44 years, respectively. Autologous reconstruction was performed on a delayed basis, an average of 21 months after mastectomy; whereas implant-based reconstruction was usually performed immediately. Younger women undergoing immediate implant reconstruction may have higher expectations, compared to women who have waited several months for delayed autologous reconstruction, the study authors suggest.
Women receiving implant reconstruction were also more likely to undergo reconstruction of both breasts. Many of these women underwent preventive double mastectomy because of high genetic risk of breast cancer.
Women undergoing autologous reconstruction were more likely to receive radiation therapy, had a higher average body weight, and were less educated. Complication rates were similar between groups, although the autologous reconstruction group had a higher rate of secondary corrective surgeries.
Both methods of breast reconstruction provided good outcomes, with similar scores for quality of life. “The study found no ideal breast reconstruction suitable for all patients,” the researchers write. “However, [it] may inform patients and medical teams in making decisions about breast reconstruction.”