title: Quality of life before reconstructive breast surgery: A preoperative comparison of patients with immediate, delayed, and major revision reconstruction.
abstract: BACKGROUND
  Women undergo breast reconstruction at different time-points in their cancer care; knowing patients' preoperative quality of life (QoL) is critical in the overall care of the patient with breast cancer. Our objective was to describe presurgical QoL among women undergoing immediate, delayed, or major revision breast reconstructive surgery at our institution.
  
  
  METHODS
  From March 2008 to February 2009, we administered preoperative BREAST-Q questionnaires to women who presented to our institution for breast reconstruction. Univariate and multivariate analyses were performed to compare patient cohorts across multiple QoL domains including body image, physical well-being, psychosocial well-being, and sexual well-being.
  
  
  RESULTS
  Of the 231 patients who presented for preoperative consultation, 176 returned the questionnaire (response rate 76%; 117 from the immediate, 21 from the delayed, and 32 from the major revision reconstruction groups, plus 6 mixed or unknown). The three groups differed significantly (P < 0.05) across four of the six domains: body image (satisfaction with breasts), psychosocial well-being, sexual well-being, and physical well-being of the chest and upper body. The immediate reconstruction group had higher (better) scores than the delayed reconstruction group, which had higher (better) scores than the major revision group.
  
  
  CONCLUSIONS
  These data suggest that women presenting for breast reconstruction at different stages of reconstruction have different baseline QoL. Such data may help us better understand patient selection, education, and expectations, and may lead to improved patient-surgeon communication.
authors: Department of Plastic Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. gedge@jhmi.edu
authors: Gedge D
authors: GD
authors: Rosson
authors: Sachin M
authors: SM
authors: Shridharani
authors: Michael
authors: M
authors: Magarakis
authors: Michele A
authors: MA
authors: Manahan
authors: Basak
authors: B
authors: Basdag
authors: Marta M
authors: MM
authors: Gilson
authors: Andrea L
authors: AL
authors: Pusic
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000523:psychology*; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D015999:Multivariate Analysis; D057234:Preoperative Period; D011788:Quality of Life; D012044:Regression Analysis; D012086:Reoperation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome