Shiba Sinha1, Olivia Ruskin2, Antonietta D'Angelo3, David McCombe4, Wayne A J Morrison5, Angela Webb4. 1. Department of Plastic, Reconstructive and Hand Surgery, St. Vincent's Hospital, Melbourne, Australia. Electronic address: shibasinha@gmail.com. 2. Department of Plastic, Reconstructive and Hand Surgery, St. Vincent's Hospital, Melbourne, Australia. 3. Department of Medicine and Surgery, University of Melbourne, Melbourne, Australia; Department of Plastic and Reconstructive Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia. 4. Department of Plastic, Reconstructive and Hand Surgery, St. Vincent's Hospital, Melbourne, Australia; Department of Plastic and Reconstructive Surgery, Peter MacCallum Cancer Centre, Melbourne, Australia. 5. Department of Plastic, Reconstructive and Hand Surgery, St. Vincent's Hospital, Melbourne, Australia; O'Brien Institute, Melbourne, Australia; Department of Surgery, St. Vincent's Hospital, Melbourne, University of Melbourne, Australia; Faculty of Health Sciences, Australian Catholic University, Melbourne, Australia.
Abstract
INTRODUCTION: Obese and overweight patients represent a challenging surgical group for autologous free-flap breast reconstruction. There is a paucity of information regarding post-operative patient-reported satisfaction in this increasingly prevalent cohort. This retrospective study aimed to determine using BREAST-Q patient-reported satisfaction amongst normal, overweight and obese patients receiving autologous free-flap breast reconstruction. METHODS: BREAST-Q (post-reconstruction) module was sent to 174 autologous breast free flap reconstruction patients between 2001 and 2012. Clinical data were collated for patients who returned questionnaires. Post-operative complications and satisfaction scores were compared between normal versus overweight and obese patients. RESULTS: A total of 101 patients (normal body mass index (BMI) = 27; overweight BMI = 48 and obese BMI = 25) completed BREAST-Q (response rate 66%). Obese and overweight patients are significantly more likely to develop major (44.8% and 31.1% vs. 29.6%) and minor (34.4% and 20% vs. 7.4%) complications in comparison to normal BMI patients (p < 0.02). Overweight and obese patients demonstrated similar levels of satisfaction compared with normal patients with the shape of their reconstructed breasts (73.2 and 72.1 vs. 71.2; p > 0.05) and overall surgical outcome (75.8 and 78.9 vs. 75.4; p > 0.05). CONCLUSIONS: Patient post-operative satisfaction is gaining increasing relevance in assessing the outcomes from autologous breast reconstruction. Overweight and obese women benefit from autologous breast reconstruction, despite being at increased risk of post-operative complications, and eventually achieve comparable levels of post-operative satisfaction. This should be reflected in pre-operative counselling. Crown
INTRODUCTION:Obese and overweight patients represent a challenging surgical group for autologous free-flap breast reconstruction. There is a paucity of information regarding post-operative patient-reported satisfaction in this increasingly prevalent cohort. This retrospective study aimed to determine using BREAST-Q patient-reported satisfaction amongst normal, overweight and obesepatients receiving autologous free-flap breast reconstruction. METHODS: BREAST-Q (post-reconstruction) module was sent to 174 autologous breast free flap reconstruction patients between 2001 and 2012. Clinical data were collated for patients who returned questionnaires. Post-operative complications and satisfaction scores were compared between normal versus overweight and obesepatients. RESULTS: A total of 101 patients (normal body mass index (BMI) = 27; overweight BMI = 48 and obese BMI = 25) completed BREAST-Q (response rate 66%). Obese and overweight patients are significantly more likely to develop major (44.8% and 31.1% vs. 29.6%) and minor (34.4% and 20% vs. 7.4%) complications in comparison to normal BMI patients (p < 0.02). Overweight and obesepatients demonstrated similar levels of satisfaction compared with normal patients with the shape of their reconstructed breasts (73.2 and 72.1 vs. 71.2; p > 0.05) and overall surgical outcome (75.8 and 78.9 vs. 75.4; p > 0.05). CONCLUSIONS:Patient post-operative satisfaction is gaining increasing relevance in assessing the outcomes from autologous breast reconstruction. Overweight and obesewomen benefit from autologous breast reconstruction, despite being at increased risk of post-operative complications, and eventually achieve comparable levels of post-operative satisfaction. This should be reflected in pre-operative counselling. Crown
Authors: Jonas A Nelson; Nikhil Sobti; Aadit Patel; Evan Matros; Colleen M McCarthy; Joseph H Dayan; Joseph J Disa; Peter G Cordeiro; Babak J Mehrara; Andrea L Pusic; Robert J Allen Journal: Ann Surg Oncol Date: 2019-12-06 Impact factor: 5.344