From McGill University; and the Jewish General Hospital.
Plast Reconstr Surg. 2021 Dec 1;148(6):882e-890e. doi: 10.1097/PRS.0000000000008506.
Direct-to-implant prepectoral breast reconstruction has recently experienced a resurgence in popularity because of its lower levels of postoperative pain and animation deformity. BREAST-Q, a well-validated patient-reported outcomes tool, was used to assess patient satisfaction and quality of life. The goal of this study was to assess patient-reported outcomes at 6-month and 1-year follow-up after direct-to-implant prepectoral breast reconstruction.
Sixty-nine consented adult patients undergoing a total of 110 direct-to-implant, prepectoral, postmastectomy breast reconstructions completed BREAST-Q questionnaires immediately preoperatively, and at 6 and 12 months thereafter.
Mean breast satisfaction decreased nonsignificantly from 61.3 preoperatively to 58.6 at 12 months after reconstruction (p = 0.32). Psychosocial well-being improved nonsignificantly from 67.1 preoperatively to 71.1 at 12-month follow-up (p = 0.26). Physical well-being of the chest was insignificantly different, from 74.4 to 73.3 at 12-month follow-up (p = 0.62). Finally, sexual well-being similarly remained nonsignificantly changed from 60.2 preoperatively, to 59.1 at 12 months (p = 0.80). The use of acellular dermal matrix and postmastectomy radiotherapy did not have any significant effects on patient-reported outcomes. Through regression analysis, neoadjuvant chemotherapy, increased age, and incidence of rippling were found to negatively influence BREAST-Q results.
Patients who underwent direct-to-implant prepectoral breast reconstruction demonstrated an overall satisfaction with their outcomes. As prepectoral breast reconstruction continues to advance and grow in popularity, patient-reported outcomes such as those presented in this study become of paramount importance in practice.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
直接置管胸肌前置乳房重建术由于术后疼痛程度较低和运动畸形程度较低，最近再次流行。BREAST-Q 是一种经过充分验证的患者报告结局工具，用于评估患者满意度和生活质量。本研究的目的是评估直接置管胸肌前置乳房重建术后 6 个月和 1 年的患者报告结局。
69 名同意的成年患者共接受了 110 例直接置管、胸肌前置、乳房切除术的乳房重建术，在术前、术后 6 个月和 12 个月时完成了 BREAST-Q 问卷。
乳房满意度从术前的 61.3 分显著下降至重建后 12 个月的 58.6 分（p = 0.32）。术前心理社会健康从 67.1 分显著改善至 12 个月随访时的 71.1 分（p = 0.26）。12 个月随访时，胸部生理健康无显著差异，从 74.4 分降至 73.3 分（p = 0.62）。最后，术前性健康从 60.2 分同样保持不变，12 个月时为 59.1 分（p = 0.80）。脱细胞真皮基质和乳房切除术放疗的使用对患者报告结局没有任何显著影响。通过回归分析，新辅助化疗、年龄增加和波纹发生率被发现对 BREAST-Q 结果产生负面影响。
接受直接置管胸肌前置乳房重建术的患者对其结果总体满意。随着胸肌前置乳房重建术的不断发展和普及，患者报告结局变得至关重要。
临床问题/证据水平：治疗，IV。
