TY - JOUR

T1 - Autologous versus implant-based breast reconstruction

T2 - A systematic review and meta-analysis of Breast-Q patient-reported outcomes

AU - Toyserkani, Navid Mohamadpour

AU - Jørgensen, Mads Gustaf

AU - Tabatabaeifar, Siavosh

AU - Damsgaard, Tine

AU - Sørensen, Jens Ahm

N1 - Copyright © 2019 Elsevier Ltd. All rights reserved.

PY - 2020

Y1 - 2020

N2 - OBJECTIVE: Breast reconstruction following mastectomy can increase the quality of life of patients. Reconstruction methods can broadly be divided into implant-based and autologous tissue reconstruction. Patient-reported outcomes following breast reconstruction are one of the most important success parameters. In this systematic review and meta-analysis, we aimed to compare the two methods using the recognized Breast-Q questionnaire.METHODS: We performed a systematic search in PubMed and EMBASE databases. Meta-analysis was performed on the five most commonly reported Breast-Q modules. RevMan 5.3 was used for statistical analysis. Methodological quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Form for Cohort Studies.RESULTS: The search strategy resulted in 219 studies of which nine studies were included in the analysis, yielding 2129 implant-based and 825 autologous breast reconstructions. Overall satisfaction with outcome as well as breast was significantly higher among patients with autologous breast reconstructions (mean Breast-Q difference between the two groups was 9.82 [3.09, 16.54], p = 0.004, and 10.33 [95% CI 5.93, 14.74], p<0.00001, respectively). Sexual and psychosocial well-being was higher among autologous breast reconstructions. There was no difference in the physical well-being.CONCLUSION: This is the first systematic review and meta-analysis to compare patient-reported outcomes of implant-based and autologous breast reconstruction. We found that autologous reconstruction yields a higher satisfaction with overall outcome and breast. These findings can aid clinicians when discussing breast reconstruction options with patients.

AB - OBJECTIVE: Breast reconstruction following mastectomy can increase the quality of life of patients. Reconstruction methods can broadly be divided into implant-based and autologous tissue reconstruction. Patient-reported outcomes following breast reconstruction are one of the most important success parameters. In this systematic review and meta-analysis, we aimed to compare the two methods using the recognized Breast-Q questionnaire.METHODS: We performed a systematic search in PubMed and EMBASE databases. Meta-analysis was performed on the five most commonly reported Breast-Q modules. RevMan 5.3 was used for statistical analysis. Methodological quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Form for Cohort Studies.RESULTS: The search strategy resulted in 219 studies of which nine studies were included in the analysis, yielding 2129 implant-based and 825 autologous breast reconstructions. Overall satisfaction with outcome as well as breast was significantly higher among patients with autologous breast reconstructions (mean Breast-Q difference between the two groups was 9.82 [3.09, 16.54], p = 0.004, and 10.33 [95% CI 5.93, 14.74], p<0.00001, respectively). Sexual and psychosocial well-being was higher among autologous breast reconstructions. There was no difference in the physical well-being.CONCLUSION: This is the first systematic review and meta-analysis to compare patient-reported outcomes of implant-based and autologous breast reconstruction. We found that autologous reconstruction yields a higher satisfaction with overall outcome and breast. These findings can aid clinicians when discussing breast reconstruction options with patients.

KW - Breast Implantation

KW - Female

KW - Humans

KW - Mammaplasty/methods

KW - Patient Reported Outcome Measures

KW - Transplantation, Autologous

U2 - 10.1016/j.bjps.2019.09.040

DO - 10.1016/j.bjps.2019.09.040

M3 - Review

C2 - 31711862

VL - 73

SP - 278

EP - 285

JO - Journal of Plastic, Reconstructive & Aesthetic Surgery (Print Edition)

JF - Journal of Plastic, Reconstructive & Aesthetic Surgery (Print Edition)

SN - 1748-6815

IS - 2

ER -