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A North American research group compared women’s levels of satisfaction for breast reconstruction following implant surgery or tissue reconstruction.
Following mastectomy, 60% of women choose to have breast reconstruction surgery. Unlike many aspects of the breast cancer these patients have survived, women are now offered a choice. They can choose between having implants and having muscle tissue from the abdomen moved up to the breasts.
A recent study has suggested that women are happier with the results of breast reconstruction when the muscle from their own abdomen is used. This type of surgery is called autologous reconstruction. However, until a recent study was done, women have not been asked about their levels of satisfaction with the different types of breast reconstruction over the long-term. The results of the study were published in JAMA.
The research group set out to see how women felt about their breasts after two years had passed since the breast reconstruction surgery. A total of 2,013 women were included in the study. In order to have a baseline to compare to, women were asked a series of questions about their breasts before the reconstruction surgery was done. These answers were compared to the answers that women provided to the same questions two years after the reconstruction.
More satisfaction with autologous reconstruction from abdomen than implants
The questions covered a range of issues, including satisfaction with the breasts, psychosocial well-being, and sexual well-being. The results showed that patients who had autologous reconstruction rather than implant placement were more satisfied overall.
The researchers speculate that this may be because the tissues used from the patients’ own abdomen undergoes the same changes in aging like breasts would. However, when an implant is placed, it stays the same shape and size over the years. This can eventually lead to an asymmetrical appearance between the reconstructed breast and the surviving breast.
Abdomen can alter in appearance and function
However, this level of satisfaction with their breasts did appear to come at a price. The results showed that the patients were getting progressively unhappier with their abdomen. In the patients undergoing autologous reconstruction, the tissue for the breasts was removed from the abdomen, altering the abdomen’s appearance and function. The researchers suggest that more research is focused into finding out why this is, and possible solutions for it.
The researchers discuss that getting evidence from the patients themselves about levels of satisfaction with breast reconstruction surgery is important, particularly so, given the intimate and personal nature of the breast reconstruction. They hope that the information from their study will help women make more informed choices about breast reconstruction surgery.
Written by Nicola Cribb, VetMB DVSc Dip.ACVS
Reference: Santosa K, Qi J, Kim H, Hamill J, Wilkins E, Pusic A. Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction. Jama Surg. 2018. doi:10.1001/jamasurg.2018.1677.