Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Oct:71:122-131.
doi: 10.1016/j.breast.2023.08.001. Epub 2023 Aug 6.

Patient-reported health-related quality of life outcomes following mastectomy for breast cancer, with immediate, delayed or no breast reconstruction: Four-year follow-up from a prospective cohort study

Affiliations

Patient-reported health-related quality of life outcomes following mastectomy for breast cancer, with immediate, delayed or no breast reconstruction: Four-year follow-up from a prospective cohort study

Kathy Dempsey et al. Breast. 2023 Oct.

Abstract

Background: Breast reconstruction (BR) improves women's health-related quality of life (HRQOL) following mastectomy for breast cancer, yet factors contributing to improved HRQOL remain unclear. This study aimed to explore the overall impact of mastectomy with or without BR on participants' perceptions of HRQOL over time in a cohort of women with high-risk breast cancer; to examine differences in mean HRQOL scores between immediate BR, delayed BR and no BR groups; to assess the influence of patient characteristics potentially associated with HRQOL scores; and to determine the feasibility of long-term collection of patient-reported outcome measures in clinical settings.

Methods: A prospective, longitudinal study of 100 women with high-risk breast cancer who underwent mastectomy with or without breast reconstruction and were likely to require post-mastectomy radiotherapy. Four validated patient-reported questionnaires, comprising 21 outcome measures relating to HRQOL, administered at baseline and up to 4 years post-mastectomy. Demographic, clinical and surgical data extracted from patient medical records.

Results: Consistently significant declines in perceptions of future health and arm symptoms, consistently significant improvements in treatment side effects, breast symptoms and fatigue, as well as significant improvements, compared to baseline, in social functioning and financial difficulties at 48 months. No significant differences in mean HRQOL scores between women given a choice of reconstructive options.

Conclusion: Similar trajectories of HRQOL scores were found in women with high-risk breast cancer who were offered a choice of BR. Informed choice may be an independent contributing factor in long-term maintenance of most HRQOL indicators at their pre-mastectomy levels.

Keywords: Breast cancer; Breast reconstruction; Health-related quality of life; Informed choice; Mastectomy; Patient preferences.

PubMed Disclaimer

Conflict of interest statement

Declaration of competing interest The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Patient-reported outcome measures (PROMs) [[23], [24], [25], [26], [27]].
Fig. 2
Fig. 2
Questionnaire Completion Rates Aus = Australia; NZ = New Zealand; t = time (t0 = baseline; t1-4 = annual follow-ups).

References

    1. Retrouvey H., Kerrebijn I., Metcalfe K.A., O'Neill A.C., McCready D.R., Hofer S.O.P., et al. Psychosocial functioning in women with early breast cancer treated with breast surgery with or without immediate breast reconstruction. Ann Surg Oncol. 2019;26:2444–2451. - PubMed
    1. Howes B.H., Watson D.I., Xu C., Fosh B., Canepa M., Dean N.R. Quality of life following total mastectomy with and without reconstruction versus breast-conserving surgery for breast cancer: a case-controlled cohort study. J Plast Reconstr Aesthetic Surg. 2016;69(9):1184–1191. - PubMed
    1. National Clinical Audit Support Programme (NCASP) 2009. National mastectomy and breast reconstruction audit (Report 2) London.
    1. Metcalfe K.A., Semple J., Quan M.L., Vadaparampil S.T., Holloway C., Brown M., et al. Changes in psychosocial functioning 1 year after mastectomy alone, delayed breast reconstruction, or immediate breast reconstruction. Ann Surg Oncol. 2012;19(1):233–241. - PubMed
    1. Malata C.M., McIntosh S.A., Purushotham A.D. Immediate breast reconstruction after mastectomy for cancer. Br J Surg. 2000;87:1455–1472. - PubMed