The Clinical Assessment Of Immediate Breast Reconstruction

The clinical assessment of immediatebreast reconstructionBackground: We cooperated with Chinese academy of medical scienceoncology hospital and others center in promoting the immediate breastreconstruction from January of 2003 to March of 2007, with staking ofChinese Society ClinicalOnconlogy(CSCO) fund. During this period, 34cases were performed and evaluated to supply information for furtherclinical work.Methods: Thirty-four cases of mastectomy with immediate breastreconstruction (IBR)were studied. We consulted both the EuropeanOrganization for Research and Treatment of Cance(EORTC) Quality-of-lifeC30 (QLQ-C30) and the Functional Assessment of CancerTherapy-Breast(FACT-B), combining our situation to designquestionnaire. We also use the Body Image Scale to investigate patientsin order to make sure our outcomes.Results: The outcomes were assessed both mailing questionnaire andtelephone to 34 patients of IBR, and we selected 67 patients of delayedbreast reconstruction(DBR) to comparison. 21 questionnaires of IBR(61.76percent)and 40 questionnaires of DBR(62.5 percent) were returned. Toconduct a statistical analysis, the Wilcoxon signed rank test, Fisher exacttests, two-sided t test, Spearman' s correlation, and factor analysisstatistics were used. Variables analyzed included patient' sage, cost, reasons for reconstruction, method and operation time ofreconstruction, and postoperative complications. Data analysis showedthat the treatment received by the two groups was similar in manyrespects. There was no statistical association a patient's satisfaction with the results (P＞0.05). The QL of IBR is less affected than DBR. With thesame method, cost of IBR is lower than DBR(F=15.462, P＜0.01); operation timeof IBR is shorter than DBR (F=10.25, P＜0.01). Patients preferred simpletechnique of reconstruction, and were satisfied with the results ofreconstruction with the method of LDF. The information for IBR was mainlypromoted by oncology surgeon and DBR by Internet and TV. The reason of IBRare psychological influence without breast and for herself. We have founda strong correlation between scar of reconstructive breast and overallaesthetic results. Although overall satisfaction with breastreconstruction is undoubtedly determined by multiple and complex clinical,emotional, and psychological factors, this study suggests thatpostoperative complications are a particularly important indicator ofdissatisfaction with reconstruction.Conclusion:1. Our results confirm that patients of IBR responses regardingsatisfaction with reconstruction will reflect smaller negativepsychological and quality-of-life aspects of mastectomy.2. IBR can be used to repair the wound of recurrent sarcoma and laterbreast cancer.3. As a result of the development of new techniques that use a skin-sparingapproach and nipple-areola-preserving envelope mastectomy with IBR,the aesthetic outcome of reconstruction can be improved. In order toimprove the satisfaction, oncology surgeon and plastic surgeon shouldcooperate to benefit patient a lot.