| Title | Prospective analysis of long-term psychosocial outcomes in breast reconstruction: two-year postoperative results from the Michigan Breast Reconstruction Outcomes Study. | | Author(s) | Atisha D, Alderman AK, Lowery JC, Kuhn LE, Davis J, Wilkins EG | | Institution | Section of Plastic Surgery, Department of Surgery, The University of Michigan Medical Center, St. Joseph Mercy Hospital, Ann Arbor VA Health Care System, Ann Arbor, MI, USA. | | Source | Ann Surg 2008 Jun; 247(6):1019-28. | | MeSH | Adaptation, Psychological
Adult
Breast Neoplasms
Emotions
Female
Humans
Interpersonal Relations
Mammaplasty
Mastectomy
Michigan
Middle Aged
Prospective Studies
Quality of Life
Questionnaires
Regression Analysis
Surgical Flaps
Time Factors
Treatment Outcome
| | Abstract | OBJECTIVE: To prospectively evaluate the psychosocial outcomes and body image of patients 2 years postmastectomy reconstruction using a multicenter, multisurgeon approach.
BACKGROUND: Although breast reconstruction has been shown to confer significant psychosocial benefits in breast cancer patients at year 1 postreconstruction, we considered the possibility that psychosocial outcomes may remain in a state of flux for years after surgery.
METHODS: Patients were recruited as part of the Michigan Breast Reconstruction Outcome Study, a 12 center, 23 surgeon prospective cohort study of mastectomy reconstruction patients. Two-sided paired sample t tests were used to compare change scores for the various psychosocial subscales. Multiple regression analysis was used to determine whether the magnitude of the change score varied by procedure type.
RESULTS: Preoperative and postoperative year 2 surveys were received from 173 patients; 116 with immediate and 57 with delayed reconstruction. For the immediate reconstruction cohort, significant improvements were observed in all psychosocial subscales except for body image. This occurred essentially independent of procedure type. In the cohort with delayed reconstruction, significant change scores were observed only in body image. Women with transverse rectus abdominis musculocutaneous flaps had significantly greater gains in body image scores (P = 0.003 and P = 0.034, respectively) when compared with expander/implants.
CONCLUSIONS: General psychosocial benefits and body image gains continued to manifest at 2 years postmastectomy reconstruction. In addition, procedure type had a surprisingly limited effect on psychosocial well being. With outcomes evolving beyond year 1, these data support the need for additional longitudinal breast reconstruction outcome studies. | | Language | eng | | Pub Type(s) | Journal Article
Multicenter Study
| | PubMed ID | 18520230 |
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