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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 7/2014

01-07-2014 | Breast Oncology

Implant Breast Reconstruction and Radiation: A Multicenter Analysis of Long-Term Health-Related Quality of Life and Satisfaction

Authors: Claudia R. Albornoz, MD, MSc, Evan Matros, MD, MMSc, Colleen M. McCarthy, MD, MS, Anne Klassen, DPhil, Stefan J. Cano, PhD, Amy K. Alderman, MD, MPH, Nancy VanLaeken, MD, Peter Lennox, MD, Sheina A. Macadam, MD, MHS, Joseph J. Disa, MD, Babak J. Mehrara, MD, Peter G. Cordeiro, MD, Andrea L. Pusic, MD, MHS

Published in: Annals of Surgical Oncology | Issue 7/2014

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Abstract

Background

Indications for radiotherapy in breast cancer treatment are expanding. Long-term satisfaction and health-related quality of life (HR-QOL), important outcomes after alloplastic breast reconstruction and radiation, have not been measured in irradiated patients by using a condition-specific, validated patient-reported outcomes instrument. The aim was to evaluate patient satisfaction and HR-QOL in patients with implant breast reconstruction and radiotherapy.

Methods

A multicenter cross-sectional survey of patients who underwent implant-based breast reconstruction from three centers in the United States and Canada, with and without radiation, was performed. Satisfaction with breasts, satisfaction with outcome, psychosocial well-being, sexual well-being, and physical well-being outcomes were evaluated using the BREAST-Q© (Reconstruction Module). Multivariable analysis was performed to evaluate the effect of radiotherapy on patient satisfaction with breasts with adjustment by patient and treatment characteristics.

Results

The response rate was 71 %, with 633 completed questionnaires returned. Mean follow-up was 3.3 years for irradiated patients (n = 219) and 3.7 years for nonirradiated patients (n = 414). Patients with radiation had significantly lower satisfaction with breasts (58.3 vs. 64.0; p < 0.01), satisfaction with outcome (66.8 vs. 71.4; p < 0.01), psychosocial well-being (66.7 vs. 70.9; p < 0.01), sexual well-being (47.0 vs. 52.3; p < 0.01), and physical well-being (71.8 vs. 75.1; p < 0.01) compared with nonirradiated patients. Multivariable analysis confirmed the negative effect of radiotherapy on satisfaction with breasts (β = −2.6; p = 0.03) when adjusted for patient and treatment factors.

Conclusions

Radiotherapy has a negative effect on HR-QOL and satisfaction with breasts in patients with implant reconstruction compared with nonirradiated patients. The information provided here can inform decision-making and help set appropriate expectations for patients undergoing implant breast reconstruction and radiation.
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Metadata
Title
Implant Breast Reconstruction and Radiation: A Multicenter Analysis of Long-Term Health-Related Quality of Life and Satisfaction
Authors
Claudia R. Albornoz, MD, MSc
Evan Matros, MD, MMSc
Colleen M. McCarthy, MD, MS
Anne Klassen, DPhil
Stefan J. Cano, PhD
Amy K. Alderman, MD, MPH
Nancy VanLaeken, MD
Peter Lennox, MD
Sheina A. Macadam, MD, MHS
Joseph J. Disa, MD
Babak J. Mehrara, MD
Peter G. Cordeiro, MD
Andrea L. Pusic, MD, MHS
Publication date
01-07-2014
Publisher
Springer US
Published in
Annals of Surgical Oncology / Issue 7/2014
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-014-3483-2

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