D Casella1, G Di Taranto2, M Marcasciano3, S Sordi4, A Kothari5, T Kovacs5, F Lo Torto6, E Cigna7, D Ribuffo6, C Calabrese8. 1. Department of Oncologic and Reconstructive Breast Surgery, "Breast Unit Integrata di Livorno, Cecina, Piombino, Elba, Azienda USL Toscana Nord Ovest", Italy. 2. Plastic Surgery Unit, Department of Surgery "P. Valdoni", Sapienza University, Rome, Italy. Electronic address: giuseppeditaranto89@gmail.com. 3. Department of Oncologic and Reconstructive Breast Surgery, "Breast Unit Integrata di Livorno, Cecina, Piombino, Elba, Azienda USL Toscana Nord Ovest", Italy; Plastic Surgery Unit, Department of Surgery "P. Valdoni", Sapienza University, Rome, Italy. 4. Oncologic and Reconstructive Surgery Breast Unit, Oncology Department, Careggi University Hospital, Florence, Italy. 5. Breast Surgery Unit, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK. 6. Plastic Surgery Unit, Department of Surgery "P. Valdoni", Sapienza University, Rome, Italy. 7. Plastic and Reconstructive Surgery Unit, Hospital of Pisa, Italy. 8. Oncologic and Reconstructive Surgery Breast Unit, Oncology Department, Careggi University Hospital, Florence, Italy; Breast Surgery Unit, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK.
Abstract
BACKGROUND: Although demand for prophylactic mastectomy is increasing over time among women at a high risk for breast cancer, there is a paucity of studies on long term patient-reported outcomes after this procedure. METHODS: Between January 2011 and January 2015, 46 patients documented BRCA1/2 mutation carriers, eligible for prophylactic nipple-sparing mastectomy (NSM) and immediate breast prosthetic reconstruction were registered at our Institution. Patients underwent NSM and subcutaneous reconstruction with implant covered by a titanium-coated polypropylene mesh (TiLoop®). The BREAST-Q questionnaire was given to patients prior to surgery and at 1 and 2 years follow-up points. Capsular contracture was evaluated by Baker scale. Surgical outcomes along with the changes in BREAST-Q score were analyzed over time. RESULTS: Complications were reported in only one case and after two years the capsular contracture rates were acceptable (grade I: 65,2%; grade II: 32,6%; grade III 2,2%). At one year and two year follow-ups patients reported high rates in the measures of overall satisfaction with breasts (72,5 and 73,7 respectively), psychosocial well-being (78,4 and 78,6), sexual well-being (58,8 and 59,4), physical well-being (77,6 and 80,6) and overall satisfaction with outcome (75,7 and 79,7). A statistically significant increase in all BREAST-domains from the preoperative to the postoperative period was reported at one and two years follow-ups (p < 0,05). CONCLUSION: Following bilateral prophylactic NSM and immediate subcutaneous reconstruction with TiLoop®, patients demonstrated high levels of satisfaction and quality of life as measured by BREAST-Q. 2-years outcomes confirmed high patient comfort with increased scores from the preoperative baseline level.
BACKGROUND: Although demand for prophylactic mastectomy is increasing over time among women at a high risk for breast cancer, there is a paucity of studies on long term patient-reported outcomes after this procedure. METHODS: Between January 2011 and January 2015, 46 patients documented BRCA1/2 mutation carriers, eligible for prophylactic nipple-sparing mastectomy (NSM) and immediate breast prosthetic reconstruction were registered at our Institution. Patients underwent NSM and subcutaneous reconstruction with implant covered by a titanium-coated polypropylene mesh (TiLoop®). The BREAST-Q questionnaire was given to patients prior to surgery and at 1 and 2 years follow-up points. Capsular contracture was evaluated by Baker scale. Surgical outcomes along with the changes in BREAST-Q score were analyzed over time. RESULTS: Complications were reported in only one case and after two years the capsular contracture rates were acceptable (grade I: 65,2%; grade II: 32,6%; grade III 2,2%). At one year and two year follow-ups patients reported high rates in the measures of overall satisfaction with breasts (72,5 and 73,7 respectively), psychosocial well-being (78,4 and 78,6), sexual well-being (58,8 and 59,4), physical well-being (77,6 and 80,6) and overall satisfaction with outcome (75,7 and 79,7). A statistically significant increase in all BREAST-domains from the preoperative to the postoperative period was reported at one and two years follow-ups (p < 0,05). CONCLUSION: Following bilateral prophylactic NSM and immediate subcutaneous reconstruction with TiLoop®, patients demonstrated high levels of satisfaction and quality of life as measured by BREAST-Q. 2-years outcomes confirmed high patient comfort with increased scores from the preoperative baseline level.
Authors: Rüdiger Klapdor; Christina Weiß; Elna Kuehnle; Fabian Kohls; Julia von Ehr; Anja Philippeit; Ursula Hille-Betz Journal: Breast Care (Basel) Date: 2020-01-24 Impact factor: 2.860
Authors: Monika Lanthaler; Rossella Spinelli; Christoph Tasch; Michael Sieb; Manuel Harfmann; Agnese Nitto; Gerhard Pierer; Thomas Bauer Journal: Breast Care (Basel) Date: 2019-09-04 Impact factor: 2.860
Authors: Abhishek Chatterjee; Maurice Y Nahabedian; Allen Gabriel; Michael Sporck; Mousam Parekh; David Macarios; Jason Hammer; Steven Sigalove Journal: Plast Reconstr Surg Glob Open Date: 2021-10-26