English summaries 9.6.2006 23/2006 vsk 61 s. 2473 - 2477

English summary: LONG-TERM SATISFACTION AFTER IMMEDIATE BREAST RECONSTRUCTION

Kaisa HerttuainenPaula MustonenLeena SetäläMarkku Härmä

Background:

The aim of this study was to evaluate patient satisfaction after immediate breast reconstruction (IBR) performed by three different surgical procedures.

Material:

Eighty patients had undergone IBR during the years 1998-2001 at our hospital. Five patients were excluded because of disease progression and death. Questionnaires were sent to 75 patients with follow-up of 3-6 years. The questionnaire contained four items assessing general satisfaction with reconstruction, one concerning the adequacy of preoperative information and two items assessing aesthetic satisfaction as separate subscales (Alderman 2000). Patients were asked to respond to each item on a continuous scale from 0 (very high satisfaction) to 10 (very low satisfaction).

Results:

The response rate was 82. The answers of three patients were excluded (one patient with implant reconstruction and two patients who lost their flaps because of immediate surgical complications, one TRAM-flap and one mini-LD-flap). The final analysis was based on 20 patients with quadrantectomy and LD-miniflap, 19 patients with skin sparing or subcutaneous mastectomy (SSM/SCM) and TRAM-flap and 19 patients with SSM/SCM and extended LD-flap. The four items about general satisfaction showed the patients to be very satisfied (all mean values less than 2). However, the fifth item assessing preoperative information about surgical options showed only moderate satisfaction (mean 3.5, SD 3.6). Aesthetic satisfaction was moderate: volume and shape of the breasts 3.8 (SD 3.5); natural feeling of the breasts 3.1 (SD 2.9). There was no statistical difference between the results for the different procedure types. Patients without postoperative radiotherapy were a little more satisfied than patients with postoperative radiotherapy.

Conclusion:

Irrespective of the surgical procedure, the patients reported high long-term general satisfaction after IBR with autologous tissue, but moderate aesthetic satisfaction.