Mastectomy Research Today is a free monthly online journal that collates and summarizes the latest research about Mastectomy, including details on breast cancer, prosthesis, recovery, surgery, complications. | ||||||||
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Does patient satisfaction with breast reconstruction change over time? Two-year results of the Michigan Breast Reconstruction Outcomes Study.Alderman AK, Kuhn LE, Lowery JC, Wilkins EG Section of Plastic Surgery, Department of Surgery, The University of Michigan, Medical Center, Ann Arbor, MI 48109-0340, USA. BACKGROUND: Previously, we found patient satisfaction with breast reconstruction at postoperative year 1 significantly higher in the autogenous tissue compared with the expander/implant population. But breast reconstructive procedures have different "aging" processes, and the point at which outcomes stabilize is unclear. So we evaluated patient satisfaction with breast reconstruction at postoperative year 2 and compared the results with those from our previous study. STUDY DESIGN: As part of the Michigan Breast Reconstruction Outcomes Study, women undergoing mastectomy reconstruction (including expander/implants and pedicle and free transverse rectus abdominis musculocutaneous flaps [TRAM]) were prospectively evaluated. Preoperatively and at postoperative years 1 and 2, women completed a questionnaire that collected a variety of validated health status information. The postoperative questionnaire had an additional seven items assessing both general and esthetic satisfaction as separate subscales. To assess the effects of procedure on satisfaction and control for possible confounding, multiple logistic regression was used. RESULTS: At year 2, patients with TRAM flaps (both free and pedicle) continued to have higher levels of esthetic satisfaction compared with expander/implant patients (odds ratio 2.8, p < 0.01). But no significant differences were appreciated in esthetic satisfaction between women with free and pedicle TRAM flaps. In regard to general satisfaction, the type of reconstruction (expander/implant, pedicle TRAM, and free TRAM) had no statistically significant effect. CONCLUSIONS: At postoperative year 2, procedural differences initially found in women's general satisfaction with breast reconstruction diminish. Specifically, women with pedicle TRAM flaps, free TRAM flaps, and expander/implants had similar levels of general satisfaction. But at year 2, patients continue to be more esthetically satisfied with autogenous tissue than with expander/implant reconstructions. Published 25 December 2006 in J Am Coll Surg, 204(1): 7-12.
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