Quality-of-life outcomes between mastectomy alone and breast reconstruction: comparison of patient-reported BREAST-Q and other health-related quality-of-life measures.

BACKGROUND: Published data on quality of life in women after breast reconstruction are inconsistent. This cross-sectional study evaluated the quality of life of women after successful breast reconstruction in comparison with those who underwent mastectomy alone.
METHODS: The quality of life was evaluated using two validated self-report questionnaires: the BREAST-Q and the RAND-36. Demographic information, patient anxiety, depression, and concerns about recurrences were measured by using standardized questionnaires. These questionnaires were sent to the participants. The quality of life of the mastectomy plus breast reconstruction group (n=92) and the mastectomy-alone group (n=45) were compared. Multiple regression analysis was used to evaluate the statistical significance of the authors' findings.
RESULTS: Women with successful breast reconstruction were significantly more satisfied with the appearance of their chest/breasts (p=0.003). They also fared better psychosocially (n=0.008) and sexually (p=0.007) than women with mastectomy alone. Furthermore, they functioned better physically (p=0.012), experiencing less pain and fewer limitations (p=0.007).
CONCLUSIONS: Successful breast reconstruction following mastectomy can greatly improve different aspects of the patient's life compared with women who do not undergo reconstructive surgery. These findings might be taken into consideration when the treating medical team and the patient study various treatment options. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.