Breast Reconstruction after Mastectomy: Evaluation of postoperative Quality of Life after mastectomy

Introduction: Consensus is that breast reconstruction after mastectomy positively influences the Quality of Life (QoL) of breast cancer patients compared to mastectomy alone. However, the results of previous studies are not conclusive. Therefore I evaluated which patients undergo a breast reconstruction and if they have a different current QoL in comparison with women without a breast reconstruction. Methods: All women who underwent a curative mastectomy between 1999-2009 were included. Patients were sent a questionnaire existing of the recently developed, validated and breast reconstruction specific BREAST-Q, additional questions from the EORTC QLQ C-30 and BR-23 and questions concerning demographical features and comorbidities. 143 patients completed the questionnaire (54%), of whom 109 underwent a mastectomy and 43 a mastectomy and breast reconstruction. The average age of the study population was 66 years, the average follow-up after mastectomy was 6.8 years. Results: Age was the only independent predictor for undergoing a breast reconstruction (OR 3.0; 95% CI 1.1-8.4). Multivariate analysis showed that breast reconstruction is an independent predictor for a higher ‘Satisfaction With Outcome’ (SWO) and ‘Sexual Well-Being’ (SxWB). Mastectomy was an independent predictor for ‘Physical Well-Being’ (PWB) (all P