Juhl Alexander A, Christensen Søren, Zachariae Robert, Damsgaard Tine E
a Plastic Surgery Research Unit, Department of Plastic and Breast Surgery , Aarhus University Hospital , Aarhus , Denmark.
b The Psychooncology Research Unit , Aarhus University Hospital , Aarhus , Denmark.
Acta Oncol. 2017 Feb;56(2):225-231. doi: 10.1080/0284186X.2016.1266087. Epub 2017 Jan 13.
An increasing number of women undergo a breast reconstruction (BR) after treatment for breast cancer. The aim of the present study was to evaluate patient-reported esthetic satisfaction, quality of life (QoL), and the association between these, following different types of BR.
All women who underwent unilateral BR in Central Denmark Region between January 2005 and July 2011 were included. Participants were sent a questionnaire package, which included the Body Image Scale, The Beck Depression Inventory, the Impact of Event Scale, and a study-specific patient-reported esthetic satisfaction scale. Additionally, patients were asked if they experienced a change in QoL owing to the BR. Based on reconstructive method and timing, participants were divided into four groups, three delayed: an abdominal flap group, a latissimus dorsi flap group, an implant ± thoracodorsal flap group; and one immediate BR group.
Of 166 eligible participants, a total of 144 women (87%) completed the questionnaire. The mean follow-up was 3.8 years. Esthetic satisfaction differed significantly between groups [F(3,139) = 8.55; p < 0.001], with abdominal flap recipients reporting the highest levels of esthetic satisfaction. No between-group differences were observed for the remaining psychosocial measures. Higher satisfaction with esthetic outcome was associated with reporting higher QoL owing to the BR (odds ratio 1.10, p<0.001; 95% CI 1.06-1.15).
Abdominal flap recipients expressed higher satisfaction with their esthetic outcome, compared to the remaining BR types. Higher esthetic satisfaction was strongly associated with reporting an experience of higher QoL.
越来越多的女性在乳腺癌治疗后接受乳房重建（BR）。本研究的目的是评估不同类型乳房重建术后患者报告的美学满意度、生活质量（QoL）以及它们之间的关联。
纳入2005年1月至2011年7月在丹麦中部地区接受单侧乳房重建的所有女性。向参与者发送了一套问卷，其中包括身体意象量表、贝克抑郁量表、事件影响量表以及一个特定研究的患者报告美学满意度量表。此外，询问患者是否因乳房重建而经历了生活质量的变化。根据重建方法和时间，参与者被分为四组，三组为延迟重建：腹壁下动脉穿支皮瓣组、背阔肌肌皮瓣组、植入物±胸背皮瓣组；一组为即刻乳房重建组。
166名符合条件的参与者中，共有144名女性（87%）完成了问卷。平均随访时间为3.8年。各组之间的美学满意度存在显著差异[F(3,139) = 8.55；p < 0.001]，腹壁下动脉穿支皮瓣接受者报告的美学满意度最高。其余心理社会指标在组间未观察到差异。对美学结果的更高满意度与因乳房重建而报告更高的生活质量相关（优势比1.10，p < 0.001；95%可信区间1.06 - 1.15）。
与其他乳房重建类型相比，腹壁下动脉穿支皮瓣接受者对其美学结果表达了更高的满意度。更高的美学满意度与报告更高的生活质量体验密切相关。
