title: Patient-Reported Outcomes in Implant-Based Breast Reconstruction Alone or in Combination with a Titanium-Coated Polypropylene Mesh - A Detailed Analysis of the BREAST-Q and Overview of the Literature.
abstract: Background:Complication rates and surgical outcomes are well reported for implant-based breast reconstruction (IBBR) using supportive materials for the inferior pole of the breast. Patient-reported outcomes (PRO) are underrepresented. The aim of this study was to compare PRO in IBBR using implants alone or in combination with a synthetic mesh.Methods and Methods:PRO was measured in patients undergoing IBBR alone or in combination with a titanium-covered polypropylene mesh (TiLOOP® Bra). In this non-randomized observational trial PRO was retrospectively assessed using the validated self-reporting BREAST-Q. The raw responses of all questions applied in each domain and transformed BREAST-Q data using the Q-Score are presented.Results:Of 90 eligible women, 42 received IBBR alone and 48 received IBBR in combination with mesh. No differences in complication rates were observed. The return rate was 67.7 % and was comparable between the groups (p = 0.117). PRO revealed no differences regarding satisfaction with breast shape (p = 0.079), outcome (p = 0.604), nipple sensitivity (p = 0.502), preoperative information (p = 0.195), office staff (p = 0.462), psychosocial well-being (p = 0.370), sexual well-being (p = 0.508) and physical well-being (p = 0.654). Significant differences were noted regarding satisfaction with the surgeon (p = 0.013) and medical staff (p = 0.035) as well as the response behavior of certain questions of the sub-domains, thus helping to further stratify PRO with regards to aesthetic outcome. However, no differences were observed in the main BREAST-Q results.Conclusion:Use of the TiLOOP® Bra in IBBR results in comparable BREAST-Q scores compared with IBBR alone. Evaluating the BREAST-Q sub-domains helps to stratify PRO more profoundly and assists in interpreting the overall results and specific research questions.
authors.affiliation: Department of Obstetrics and Gynecology - Breast Unit, Klinikum Südstadt Rostock, University of Rostock, Rostock.
authors.forename: M
authors.initials: M
authors.lastname: Dieterich
authors.affiliation: Department of Obstetrics and Gynecology - Breast Unit, Klinikum Südstadt Rostock, University of Rostock, Rostock.
authors.forename: J
authors.initials: J
authors.lastname: Angres
authors.affiliation: Department of Obstetrics and Gynecology - Breast Unit, Klinikum Südstadt Rostock, University of Rostock, Rostock.
authors.forename: J
authors.initials: J
authors.lastname: Stubert
authors.affiliation: Department of Obstetrics and Gynecology - Breast Unit, Klinikum Südstadt Rostock, University of Rostock, Rostock.
authors.forename: A
authors.initials: A
authors.lastname: Stachs
authors.affiliation: Department of Obstetrics and Gynecology - Breast Unit, Klinikum Südstadt Rostock, University of Rostock, Rostock.
authors.forename: T
authors.initials: T
authors.lastname: Reimer
authors.affiliation: Department of Obstetrics and Gynecology - Breast Unit, Klinikum Südstadt Rostock, University of Rostock, Rostock.
authors.forename: B
authors.initials: B
authors.lastname: Gerber
keywords: BREAST-Q; TiLOOP® Bra; breast reconstruction; mesh; patient-reported outcome; quality of life