title: Predictors of satisfaction and quality of life following post-mastectomy breast reconstruction.
abstract: OBJECTIVE
  Breast reconstruction is associated with multiple psychological benefits. However, few studies have identified clinical and psychological factors associated with improved satisfaction and quality of life. This study examined factors, which predict satisfaction with breast appearance, outcome satisfaction and quality of life following post-mastectomy breast reconstruction.
  
  
  METHODS
  Women who underwent post-mastectomy breast reconstruction between 2010 and 2016 received a postal questionnaire consisting of The BREAST-Q Patient Reported Outcomes Instrument, The European Organisation for Research and Treatment of Cancer QLQ-30 Questionnaire, The Patient and Observer Scar Assessment Scale, and a series of Visual-Analogue Scales. One hundredforty-eight women completed the questionnaire, a 56% response rate.
  
  
  RESULTS
  Hierarchical multiple regression analyses revealed psychosocial factors accounted for 75% of the variance in breast satisfaction, 68% for outcome satisfaction, and 46% forquality of life. Psychosocial well-being emerged as a significant predictor of satisfaction with breast appearance (β = .322) and outcome satisfaction (β = .406). Deep inferior epigastric perforator flap patients reported greater satisfaction with breast appearance (β = .120) and outcome satisfaction (β = .167).
  
  
  CONCLUSIONS
  This study extends beyond the limited research by distinguishing between satisfaction with breast appearance and outcome satisfaction. The study provides evidence for the role of psychosocial factors predicting key patient reported outcomes and demonstrates the importance of psychosocial well-being and reconstruction type. The findings also highlight the need for healthcare providers to consider the psychosocial well-being of patients both preoperatively and post operatively and provide preliminary evidence for the use of deep inferior epigastric perforator reconstructions over other types of reconstructive procedures.
authors.affiliation: Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
authors.forename: Hannah
authors.identifier: http://orcid.org/0000-0003-2677-2626
authors.initials: H
authors.lastname: Matthews
authors.affiliation: Ealing Hospital, Southall, UK.
authors.forename: Natalie
authors.initials: N
authors.lastname: Carroll
authors.affiliation: Centre for Applied Biological and Exercise Sciences, Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
authors.forename: Derek
authors.initials: D
authors.lastname: Renshaw
authors.affiliation: Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Turner
authors.affiliation: University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Alan
authors.initials: A
authors.lastname: Park
authors.affiliation: University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Jo
authors.initials: J
authors.lastname: Skillman
authors.affiliation: University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: McCarthy
authors.affiliation: Centre for Technology Enabled Health Research, Faculty of Health and Life Sciences, Coventry University, Coventry, UK.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Grunfeld
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000523:psychology* / Q000601:surgery; D005260:Female; D006801:Humans; D016462:Mammaplasty / Q000379:methods* / Q000523:psychology*; D008408:Mastectomy / Q000523:psychology*; D008875:Middle Aged; D010549:Personal Satisfaction; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: breast cancer; breast reconstruction; cancer; oncology; quality of life; satisfaction and survivorship