Health-related quality of life assessment after breast reconstruction.
BACKGROUND
Health-related quality of life (HRQL) is an important outcome following breast reconstruction. This study evaluated current methods of HRQL assessment in patients undergoing latissimus dorsi breast reconstruction, hypothesizing that early surgical morbidity would be reflected by poorer HRQL scores.


METHODS
Patients completed the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30 and breast module (QLQ-BR23), the Functional Assessment of Cancer Therapy (FACT) general measure, and breast module and arm subscale (FACT-B + 4), and the Body Image Scale and Hospital Anxiety and Depression Scale (HADS) 3 months after surgery. They also reported additional HRQL problems not included in the questionnaires. HRQL scores were compared between patients with and without early surgical morbidity.


RESULTS
Sixty women completed the questionnaires, of whom 25 (42 per cent) experienced complications. All EORTC and FACT subscale and HADS scores were similar in patients with or without morbidity. Women with complications were twice as likely to report feeling less feminine and dissatisfied with the appearance of their scar than those without problems. Thirty-two women (53 per cent) complained of problems not covered by the questionnaires, most commonly donor-site morbidity.


CONCLUSIONS
Existing HRQL instruments are not sufficiently sensitive to detect clinically relevant problems following breast reconstruction.
Potter
S
S
Department of Clinical Sciences at South Bristol, University of Bristol, Bristol Royal Infirmary, Bristol, UK. Shelley.Potter@bristol.ac.uk
Thomson
H J
HJ
Greenwood
R J
RJ
Hopwood
P
P
Winters
Z E
ZE
D001828:Body Image; D001943:Breast Neoplasms / Q000601:surgery; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000523:psychology*; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires / Q000592:standards*; D016896:Treatment Outcome