Flap to Mastectomy Mass: Are Higher Ratios Associated with Greater Breast Reconstruction Satisfaction?

Autor:	Long AS; Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut., Ching AH; Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut., Hauc SC; Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut., Mozaffari MA; Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut., Junn AH; Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut., Rivera JC; Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut., Almeida MN; Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut., Alper DP; Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut., Allam O; Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut., Alperovich M; Division of Plastic Surgery, Department of Surgery, Yale University School of Medicine, New Haven, Connecticut.
Jazyk:	angličtina
Zdroj:	Journal of reconstructive microsurgery [J Reconstr Microsurg] 2023 Mar; Vol. 39 (3), pp. 209-213. Date of Electronic Publication: 2022 Jun 25.
DOI:	10.1055/a-1885-1540
Abstrakt:	Background:  Autologous breast reconstruction is associated with superior patient-reported outcomes compared with prosthetic techniques, but little is known about the relationship between autologous flap mass and patient satisfaction. We hypothesized that a higher differential mass (ratio of flap mass to mastectomy mass) would be associated with greater satisfaction with reconstruction. Methods:  In this retrospective study, patients who underwent autologous breast reconstruction between 2015 and 2020 with a deep inferior epigastric perforator (DIEP) flap completed the BREAST-Q survey. Multivariate linear regression models were used to examine the relationship between differential mass and patient satisfaction. Models controlled for body mass index (BMI), age at surgery, reconstruction size preference, number of surgeries, previous surgery failure, whether the patient underwent radiation therapy, and whether reconstruction was unilateral or bilateral. Results:  Overall, 45 patients (70 breasts) completed the BREAST-Q survey. Mean age at reconstruction was 52.2 years and mean time to survey completion following surgery was 21.1 months. Most patients (59.4%) desired a smaller breast after reconstruction. The mean differential mass was +26.3% (flap mass greater than mastectomy mass). Differential mass was positively associated with all satisfaction measures with results being significant for satisfaction with breasts scores ( p =0.032). Conclusion:  In this preliminary study, a higher ratio of autologous flap mass to mastectomy mass was associated with overall higher patient-reported satisfaction. A 1:1 flap to mastectomy mass ratio may not adequately reapproximate desired breast size or shape. Larger autologous flap mass may be favorable for long-term patient satisfaction, and future studies should investigate the relationship between differential mass and breast esthetics. Competing Interests: None declared. (Thieme. All rights reserved.)
Databáze:	MEDLINE
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