scholarly journals Impact of Contralateral Symmetry Procedures on Long-Term Patient-Reported Outcomes following Unilateral Prosthetic Breast Reconstruction

2018 ◽  
Vol 35 (02) ◽  
pp. 124-128 ◽  
Author(s):  
Shantanu Razdan ◽  
Hina Panchal ◽  
Claudia Albornoz ◽  
Andrea Pusic ◽  
Colleen McCarthy ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Patient Reported Outcomes ◽  
Statistical Significance ◽  
Multivariable Analysis ◽  
Well Being ◽  
Contralateral Breast ◽  
Prosthetic Reconstruction ◽  
Patient Reported ◽  
The Impact

Background One aim of unilateral postmastectomy breast reconstruction (BR) is to restore symmetry with the contralateral breast. As such, unilateral prosthetic reconstruction often requires a contralateral symmetry procedure (CSP). There is sparse literature on the impact of CSPs on long-term patient-reported outcomes (PROs) such as satisfaction and health-related quality of life (HRQoL). This study aims to describe PROs following CSPs, using a validated PRO tool, BREAST-Q. The hypothesis is that CSPs are associated with greater patient-reported satisfaction and HRQoL. Methods This study is a single institutional analysis of prospectively collected BREAST-Q scores of patients who underwent unilateral prosthetic BR during 2011 to 2015. Women 18 years and older with BREAST-Q scores measured ≥ 9months after BR with or without CSP(s) at the time of expander replacement were included. Patients were classified into four subcohorts: augmentation, mastopexy, reduction, and no symmetry procedure (controls). Sociodemographic, clinical characteristics, and BREAST-Q scores were analyzed. Multivariable linear regression was performed. Results Of 553 patients, 67 (12%) underwent contralateral augmentation, 68 (12%) mastopexy, 93(17%) reduction, and 325 (59%) were controls. Mean follow-up time was 52 months. Satisfaction with breast and outcomes were higher in the augmentation compared with the control groups (p = 0.01). On multivariable analysis, augmentation remained an independent predictor of satisfaction with breast (p = 0.04). Physical well-being scores were lower for contralateral mastopexy and reduction compared with the controls with a trend toward statistical significance on multivariable models. Psychological and sexual well-being was similar across groups. Conclusion Prosthetic reconstruction with contralateral breast augmentation was associated with greater satisfaction with breast and reconstructive outcome. In contrast, breast reduction and mastopexy procedures demonstrated equivalent satisfaction with breasts compared with controls but may be associated with lower physical well-being. Such information can be used to improve the shared decision-making process for women who choose unilateral prosthetic BR.

Feasibility and acceptability of patient-reported outcomes data collection for clinical care following breast reconstruction.

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. 9042-9042 ◽  
Author(s):  
Andrea Pusic ◽  
Anne Klassen ◽  
Amie Scott ◽  
Stefan Cano ◽  
Marwan Shouery ◽  
...  
Keyword(s):  
Data Collection ◽  
Breast Reconstruction ◽  
Patient Reported Outcomes ◽  
Breast Surgery ◽  
Clinical Care ◽  
Well Being ◽  
Privacy And Security ◽  
Patient Reports ◽  
Patient Reported ◽  
The Impact

9042 Background: To date, systematic measurement of patient-reported outcomes (PROs) has played an important role in cancer research, but not in routine clinical care. Our objective was to evaluate the feasibility of developing and piloting an electronic PRO data collection in clinical care among breast reconstruction patients using the BREAST-Q, a previously developed condition-specific PRO measure for breast surgery patients that measures quality of life (e.g. psychosocial, physical and sexual well-being) as well as patient satisfaction (e.g. satisfaction with breasts, with information, with surgeon). Methods: The BREAST-Q was loaded to the MSKCC WebCore, a generic electronic patient-reporting platform adhering to strict privacy and security standards. Patients attending visits at the MSKCC Breast Reconstruction Clinic were asked to complete the BREAST-Q electronically prior to scheduled visits. For patients with email addresses, a reminder with web-link to the questionnaire was emailed automatically prior to the visit. Results: Over a 9 month start-up period, BREAST-Q surveys were completed by 1442 patients. Patients completed the questionnaire at set time points before and after surgery. A total of 2340 BREAST-Q surveys were completed overall. Mean completion time was 5:53 minutes. Acceptability was high with both patients and clinical staff contributing positive comments along with suggestions for improvement via email. Conclusions: This pilot experience suggests that ePRO data can be efficiently collected among outpatient breast surgery patients with high acceptability. In the next phase of this project, we will introduce real-time individual patient reports to the clinical team and evaluate the impact of this information on clinical care and quality improvement.

scholarly journals O58: THE IMPACT OF RADIOTHERAPY ON PATIENT-REPORTED OUTCOMES OF IMMEDIATE IMPLANT-BASED BREAST RECONSTRUCTION: RESULTS OF A PROSPECTIVE MULTICENTRE COHORT STUDY

2021 ◽  
Vol 108 (Supplement_1) ◽  
Author(s):  
E Sewart ◽  
N Turner ◽  
EJ Conroy ◽  
R Cutress ◽  
J Skillman ◽  
...  
Keyword(s):  
Cohort Study ◽  
Breast Reconstruction ◽  
Patient Reported Outcomes ◽  
Random Effect ◽  
Well Being ◽  
Patient Reported Outcome ◽  
Complication Rates ◽  
Informed Decisions ◽  
Patient Reported ◽  
The Impact

Abstract Introduction Post-mastectomy radiotherapy (PMRT) is increasing given to improve breast cancer outcomes but can increase complication rates following implant-based breast reconstruction (IBBR). Little, however, is known about the impact of PMRT on patient-reported outcomes (PROs) of IBBR, especially in the context of mesh-assisted techniques. Method 2108 consecutive women undergoing IBBR at 81 UK centres were prospectively recruited between 2014 and 2016. Demographic, operative, oncological and 3-month complication data were collected, and patients who consented received post-operative questionnaires. An 18-month questionnaire assessed PROs using the validated BREAST-Q. The effect of IBBR on PROs was investigated using mixed-effects regression models adjusted for clinically relevant confounders and including a random effect to account for potential clustering by centre. Result 1693 iBRA participants underwent mastectomy for malignancy, of whom 1187 (70%) consented to receive the 18-month questionnaire and 732 (43%) completed it. Patients undergoing PMRT (n=214) reported significantly worse scores across 3 BREAST-Q domains: satisfaction with breasts (-6.27 points, p=0.008, 95% confidence interval (CI)[-10.91,-1.63]), satisfaction with outcome (-7.53 points, p=0.002, CI[-12.20,-2.85]) and physical well-being (-6.55 points, p<0.001, CI[-9.43,-3.67]). Overall satisfaction was worse in the PMRT group (OR 0.497, p=0.002, CI[0.32,0.77]). Use of biological mesh did not ameliorate the impact of PMRT on patient satisfaction (interaction term p-values [0.173 - 0.826]). Conclusion: PMRT adversely affects PROs of IBBR. This should be discussed with patients considering IBBR, especially if PMRT is anticipated or indications are borderline, to enable informed decisions regarding oncological and reconstructive options. Abbrev PMRT: post-mastectomy radiotherapy, PRO: patient-reported outcome Take-home message This multicentre, prospective cohort study of 732 patients undergoing implant-based breast reconstruction demonstrates worse 18-month patient-reported outcomes in women who received post-mastectomy radiotherapy than those who did not. These data should be discussed with patients to help them make informed decisions about reconstructive surgery.

scholarly journals Long-term Patient-Reported Outcomes in Postmastectomy Breast Reconstruction

JAMA Surgery ◽  
2018 ◽  
Vol 153 (10) ◽  
pp. 891 ◽  
Author(s):  
Katherine B. Santosa ◽  
Ji Qi ◽  
Hyungjin M. Kim ◽  
Jennifer B. Hamill ◽  
Edwin G. Wilkins ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Patient Reported Outcomes ◽  
Patient Reported

The Impact of Comorbid Conditions on Long-Term Patient-Reported Outcomes From Burn Survivors

2020 ◽  
Vol 41 (5) ◽  
pp. 956-962
Author(s):  
Clifford C Sheckter ◽  
Kevin Li ◽  
Gretchen J Carrougher ◽  
Tam N Pham ◽  
Nicole S Gibran ◽  
...  
Keyword(s):  
Mental Illness ◽  
Alcohol Use ◽  
Mental Component Summary ◽  
Patient Reported Outcomes ◽  
Alcohol Use Disorder ◽  
Negatively Associated ◽  
Risk Of Death ◽  
Patient Reported ◽  
The Impact

Abstract Preburn comorbidities increase the risk of death in the acute phase, and negatively impact quality of life among survivors. Investigations to date have only evaluated comorbidities as indices, limiting the ability to target conditions and develop strategies for risk reduction. Therefore, we aimed to evaluate the differential effects of specific conditions on long-term, patient-reported outcomes after burn injury. A prospectively maintained trauma registry was merged with a longitudinal database of patient-reported outcomes from a regional burn center from 2007 to 2018. Demographic data, injury-specific information, and the prevalence of 20 comorbidities were systematically documented. The impact of comorbidities on responses to Short Form-12/Veterans RAND 12 (SF/VR-12) health surveys at 6, 12, and 24 months postinjury was evaluated with generalized linear models. The merged dataset included 493 adult participants. Median age was 46 years (interquartile range, IQR 32–57 years), and 72% were male. Median burn size was 14% TBSA (IQR 5–28%). Seventy percent of participants had ≥1 comorbidity (median 1 comorbidity/participant; IQR 0–2 comorbidities). SF/VR-12 mental component summary scores at 6 and 12 months postinjury were negatively associated with mental illness (P < .001, P = .013). SF/VR-12 physical component summary (PCS) scores were negatively associated with smoking (P = .019), diabetes (P = .001), and alcohol use disorder (P = .001) at 6-month follow-up. Twelve-month SF/VR-12 PCS scores were negatively associated with prior trauma admission (P = .001) and diabetes (P = .042). Twenty-four-month SF/VR-12 PCS scores were negatively associated with mental illness (P = .003). Smoking, alcohol use disorder, and diabetes were associated with lower PCS scores 6 months after injury; diabetes persisted as a negatively associated covariate at 12 months. Mental component summary scores were negatively associated with mental illness 6 and 12 months postinjury. Integrated models of postdischarge comorbidity management need to be tested in burn patients.

scholarly journals Immediate breast reconstruction after mastectomy: what are the long-term prospects?

2010 ◽  
Vol 92 (3) ◽  
pp. 193-197 ◽  
Author(s):  
Jennifer E Rusby ◽  
Ruth A Waters ◽  
Peter G Nightingale ◽  
David W England
Keyword(s):  
Breast Reconstruction ◽  
Time Course ◽  
Statistical Significance ◽  
Objective Measure ◽  
Immediate Breast Reconstruction ◽  
Immediate Reconstruction ◽  
Late Failure ◽  
Initial Surgery ◽  
The Impact

INTRODUCTION Immediate breast reconstruction after mastectomy has known psychological and financial advantages but it is difficult to compare the outcome of various methods of reconstruction. Re-operation rates are an objective measure of surgical intervention required to attain and maintain acceptable cosmesis. PATIENTS AND METHODS A series of 95 patients (110 immediate reconstructions) was analysed for number of re-operations required within 5 years of initial surgery, magnitude of procedures, ‘survival’ of the reconstruction and effect of radiotherapy. RESULTS Although more intervention was seen in patients with implant-based reconstruction and the time-course over which autologous and implant-based reconstructions fail is different these did not reach statistical significance. Radiotherapy has a significant effect on failure of implant-based reconstruction. CONCLUSIONS Long-term, large studies of immediate reconstruction are required to assess adequately the impact of type of reconstruction on re-operation rates. The National Mastectomy and Breast Reconstruction Audit is ideally placed to provide answers to remaining questions about longevity of immediate breast reconstruction and the effect that late failure has on patient satisfaction.

scholarly journals Imageless computer assisted navigation in ceramic-on-ceramic total hip arthroplasty vs. manual approach: a single-centre retrospective study

10.29007/9gpf ◽  
2019 ◽  
Author(s):  
John McLoughlin ◽  
Mo Mathew ◽  
Stephen Grant
Keyword(s):  
Total Hip Arthroplasty ◽  
Hip Arthroplasty ◽  
Patient Reported Outcomes ◽  
Statistical Significance ◽  
Computer Assisted ◽  
Total Hip ◽  
Patient Reported ◽  
Cup Positioning

Background: Acetabular cup positioning is vital to the long-term survivorship of total hip arthroplasty (THA). Malalignment has been linked to dislocation, wear and osteolysis. Although there are many studies demonstrating the reduction in variability of cup positioning with computer-assisted techniques, there are relatively few reporting long-term patient reported outcomes and revision rates. Aim: The aim of this study was to review whether those patients who underwent navigated THA had better long-term survivorship or better patient reported outcomes. Methods: We compared revision rates and Oxford hip scores of 152 THAs (47 navigated and 105 non-navigated) performed at a single site between 2003 and 2008, with a minimum follow-up of 10 years. Results: 9 of the non-navigated and none of the navigated hips were revised at 10 year follow-up (p=0.057). There were no observable differences in 10-year Oxford hip scores between the navigated and non-navigated hips, 44.82 and 43.38 respectively. Conclusion: With respect to the rate of revision, although statistical significance was not achieved, it can be shown from our data that there was a clinically significant reduction in revision rates with navigated vs. non-navigated techniques. More data with higher patient numbers in the navigated cohort may be required to validate the results of our study.

scholarly journals The Impact of Radiotherapy on Patient-reported Outcomes of Immediate Implant-based Breast Reconstruction With and Without Mesh

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Emma Sewart ◽  
Nicholas L. Turner ◽  
Elizabeth J. Conroy ◽  
Ramsey I. Cutress ◽  
Joanna Skillman ◽  
...  
Keyword(s):  
Breast Reconstruction ◽  
Patient Reported Outcomes ◽  
Patient Reported ◽  
Immediate Implant ◽  
The Impact
Sign in / Sign up

Export Citation Format

Share Document