Breast reconstruction more satisfying than implants after cancer, survey says

June 20 (UPI) — Patients who had breast reconstruction after a mastectomy as part of breast cancer treatment had better satisfaction and higher quality of life than those with implants, according to a survey.

Researchers from Brigham and Women’s Hospital evaluated the satisfaction and well-being of 2,013 women across the United States before and two years after initial surgery. Their findings were published Wednesday in the Journal of the American Medical Association Surgery.

Among those who undergo a mastectomy to treat breast cancer in the United States, more than 60 percent choose breast reconstruction, according to a study of 20,560 women from 1998 to 2007 in the Journal of Clinical Oncology.

For the new survey, researchers analyzed results from the Mastectomy Reconstruction Outcomes Consortium, which included patients from 11 centers –1,490 with implants and 523 autologous patients — from February 2012 to July 2015.

In autologous — or “flap” breast reconstruction — skin, fat or muscle from elsewhere in the body is used to rebuild the breast. Implants can be filled with saline or silicone gel.

“Patient-centered data can best inform patients and clinicians about the potential risks and expected outcomes of breast reconstruction when making a decision between implant-based or autologous breast reconstruction,” Dr. Andrea L. Pusic, chief of plastic and reconstructive surgery at Brigham Health, said in a press release. “Given the personal and intimate nature of breast reconstruction, patient-centered data are arguably the best measures of outcomes.”

Researchers measured scores based on the BREAST-Q, which measures satisfaction with breasts, psychosocial well-being, physical well-being and sexual well-being on a 0 to 100 scale, with higher numbers indicating more satisfaction and happiness with the outcome of treatment choice.

Two years after the surgery, patients who chose breast reconstruction had an 7.94 percent higher level of satisfaction with their breasts, 3.27 percent more psychological well-being and 5.5 percent more sexual well-being. But they had only 1.7 percent more physical chest well-being, even though two-thirds of the patients had muscle-sparing or perforator flap procedures.

Among patients who underwent implant-based reconstruction, the satisfaction worsened over time. Researchers said it was possible due to symmetry issues and inability of the implant to age naturally.

The researchers say they want to further study the association of type of reconstruction with patient-reported outcomes when radiation is required.

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