Minji Kim, Perri Vingan, Lillian A Boe, Babak J Mehrara, Carrie S Stern, Robert J Allen, Jonas A Nelson
{"title":"自体乳房再造术后对乳房的满意度：评估相关因素和修改的影响。","authors":"Minji Kim, Perri Vingan, Lillian A Boe, Babak J Mehrara, Carrie S Stern, Robert J Allen, Jonas A Nelson","doi":"10.1097/PRS.0000000000011571","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Autologous breast reconstruction (ABR) may confer higher patient-reported outcomes than implant breast reconstruction, but an in-depth examination of factors associated with satisfaction after ABR is lacking. The authors aimed to determine independent predictors of 1-year satisfaction with breasts after ABR and assess the importance of elective procedures on satisfaction.</p><p><strong>Methods: </strong>A retrospective analysis of patients who underwent abdominally based ABR between 2010 and 2021 and completed the BREAST-Q Satisfaction with Breasts module at 1 year was performed. Elective procedures consisted of breast revision and nipple-areola complex reconstruction.</p><p><strong>Results: </strong>A total of 959 patients were included. Satisfaction with Breasts score improved from 53 (interquartile range [IQR], 44 to 64) preoperatively to 64 (IQR, 53 to 78) at 1 year postoperatively ( P < 0.001). Factors significantly associated with decreased postoperative score included lower preoperative scores (β = 0.19 [95% CI, 0.08 to 0.31]; P = 0.001), older age (β = -0.17 [95% CI, -0.34 to -0.01]; P = 0.042), Asian race (versus White, β = -6.7 [95% CI, -12 to -1.7]; P = 0.008), and a history of psychiatric diagnoses (β = -3.4 [95% CI, -6.2 to -0.66]; P = 0.015). Patients who received radiation therapy (β = -5.6 [95% CI, -9.0 to -2.3]; P = 0.001) or had mastectomy skin flap/nipple necrosis (β = -3.8 [95% CI, -7.6 to -0.06]; P = 0.046) also had significantly decreased scores. Satisfaction with Breasts scores improved significantly after breast revision procedures (from 54 [IQR, 42 to 65] to 65 [IQR, 54 to 78]; P < 0.001), and nipple-areola complex reconstruction (from 58 [IQR, 47 to 71] to 67 [IQR, 57 to 82]; P < 0.001).</p><p><strong>Conclusions: </strong>Multiple independent patient and treatment level factors are associated with lower 1-year Satisfaction with Breasts scores following ABR. Elective procedures have the potential to improve satisfaction. Understanding these findings is imperative for optimizing clinical decision-making and managing expectations.</p><p><strong>Clinical question/level of evidence: </strong>Risk, III.</p>","PeriodicalId":20128,"journal":{"name":"Plastic and reconstructive surgery","volume":" ","pages":"235-244"},"PeriodicalIF":3.2000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628637/pdf/","citationCount":"0","resultStr":"{\"title\":\"Satisfaction with Breasts following Autologous Reconstruction: Assessing Associated Factors and the Impact of Revisions.\",\"authors\":\"Minji Kim, Perri Vingan, Lillian A Boe, Babak J Mehrara, Carrie S Stern, Robert J Allen, Jonas A Nelson\",\"doi\":\"10.1097/PRS.0000000000011571\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Autologous breast reconstruction (ABR) may confer higher patient-reported outcomes than implant breast reconstruction, but an in-depth examination of factors associated with satisfaction after ABR is lacking. The authors aimed to determine independent predictors of 1-year satisfaction with breasts after ABR and assess the importance of elective procedures on satisfaction.</p><p><strong>Methods: </strong>A retrospective analysis of patients who underwent abdominally based ABR between 2010 and 2021 and completed the BREAST-Q Satisfaction with Breasts module at 1 year was performed. Elective procedures consisted of breast revision and nipple-areola complex reconstruction.</p><p><strong>Results: </strong>A total of 959 patients were included. Satisfaction with Breasts score improved from 53 (interquartile range [IQR], 44 to 64) preoperatively to 64 (IQR, 53 to 78) at 1 year postoperatively ( P < 0.001). Factors significantly associated with decreased postoperative score included lower preoperative scores (β = 0.19 [95% CI, 0.08 to 0.31]; P = 0.001), older age (β = -0.17 [95% CI, -0.34 to -0.01]; P = 0.042), Asian race (versus White, β = -6.7 [95% CI, -12 to -1.7]; P = 0.008), and a history of psychiatric diagnoses (β = -3.4 [95% CI, -6.2 to -0.66]; P = 0.015). Patients who received radiation therapy (β = -5.6 [95% CI, -9.0 to -2.3]; P = 0.001) or had mastectomy skin flap/nipple necrosis (β = -3.8 [95% CI, -7.6 to -0.06]; P = 0.046) also had significantly decreased scores. Satisfaction with Breasts scores improved significantly after breast revision procedures (from 54 [IQR, 42 to 65] to 65 [IQR, 54 to 78]; P < 0.001), and nipple-areola complex reconstruction (from 58 [IQR, 47 to 71] to 67 [IQR, 57 to 82]; P < 0.001).</p><p><strong>Conclusions: </strong>Multiple independent patient and treatment level factors are associated with lower 1-year Satisfaction with Breasts scores following ABR. Elective procedures have the potential to improve satisfaction. Understanding these findings is imperative for optimizing clinical decision-making and managing expectations.</p><p><strong>Clinical question/level of evidence: </strong>Risk, III.</p>\",\"PeriodicalId\":20128,\"journal\":{\"name\":\"Plastic and reconstructive surgery\",\"volume\":\" \",\"pages\":\"235-244\"},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11628637/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Plastic and reconstructive surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/PRS.0000000000011571\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/6/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Plastic and reconstructive surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PRS.0000000000011571","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/10 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"SURGERY","Score":null,"Total":0}
Satisfaction with Breasts following Autologous Reconstruction: Assessing Associated Factors and the Impact of Revisions.
Background: Autologous breast reconstruction (ABR) may confer higher patient-reported outcomes than implant breast reconstruction, but an in-depth examination of factors associated with satisfaction after ABR is lacking. The authors aimed to determine independent predictors of 1-year satisfaction with breasts after ABR and assess the importance of elective procedures on satisfaction.
Methods: A retrospective analysis of patients who underwent abdominally based ABR between 2010 and 2021 and completed the BREAST-Q Satisfaction with Breasts module at 1 year was performed. Elective procedures consisted of breast revision and nipple-areola complex reconstruction.
Results: A total of 959 patients were included. Satisfaction with Breasts score improved from 53 (interquartile range [IQR], 44 to 64) preoperatively to 64 (IQR, 53 to 78) at 1 year postoperatively ( P < 0.001). Factors significantly associated with decreased postoperative score included lower preoperative scores (β = 0.19 [95% CI, 0.08 to 0.31]; P = 0.001), older age (β = -0.17 [95% CI, -0.34 to -0.01]; P = 0.042), Asian race (versus White, β = -6.7 [95% CI, -12 to -1.7]; P = 0.008), and a history of psychiatric diagnoses (β = -3.4 [95% CI, -6.2 to -0.66]; P = 0.015). Patients who received radiation therapy (β = -5.6 [95% CI, -9.0 to -2.3]; P = 0.001) or had mastectomy skin flap/nipple necrosis (β = -3.8 [95% CI, -7.6 to -0.06]; P = 0.046) also had significantly decreased scores. Satisfaction with Breasts scores improved significantly after breast revision procedures (from 54 [IQR, 42 to 65] to 65 [IQR, 54 to 78]; P < 0.001), and nipple-areola complex reconstruction (from 58 [IQR, 47 to 71] to 67 [IQR, 57 to 82]; P < 0.001).
Conclusions: Multiple independent patient and treatment level factors are associated with lower 1-year Satisfaction with Breasts scores following ABR. Elective procedures have the potential to improve satisfaction. Understanding these findings is imperative for optimizing clinical decision-making and managing expectations.
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For more than 70 years Plastic and Reconstructive Surgery® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. Plastic and Reconstructive Surgery® , the official journal of the American Society of Plastic Surgeons, is a benefit of Society membership, and is also available on a subscription basis.
Plastic and Reconstructive Surgery® brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, cosmetic surgery, as well as news on medicolegal issues. The cosmetic section provides expanded coverage on new procedures and techniques and offers more cosmetic-specific content than any other journal. All subscribers enjoy full access to the Journal''s website, which features broadcast quality videos of reconstructive and cosmetic procedures, podcasts, comprehensive article archives dating to 1946, and additional benefits offered by the newly-redesigned website.
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