Immediate Versus Delayed Breast Reconstruction In BREAST-Q Scores

Objective: Surgical methods and postoperative complications are different among patients who receive breast reconstruction and oncoplastic surgery in different patients,which primarily accounts for the difference in patient satisfaction.The study of the PRO after breast reconstruction helps to transmit the evidence of the best method of breast reconstruction and oncoplastic surgery and to guide the further clinical decision.Methods: The main purpose of this study is to,to observe and evaluate the index of postoperative outcome of patients,to compare the postoperative complications and patient-reported outcome(BREAST-Q)of different breast reconstruction methods,and to analyze theirs factors by constructing a prospective cohort of breast reconstruction and oncoplastic therapy.Results: From March 2020 to December 2020,a total of 102 breast cancer patients underwent breast reconstruction in the breast center of our hospital were included in this study,and 74 BREAST-Q questionnaires were distributed.52 questionnaires were collected,with a response rate of 70.2%.There were 11 patients with complications 3 months after breast reconstruction(21.15%).The highest incidence of postoperative complications was delayed wound healing in 6 cases(11.50%),followed by subcutaneous effusion in 3cases(5.77%).Chi-square test was used to analyze whether there are differences of postoperative complications in different BMI groups.The results showed that the difference among the three groups was statistically significant(p=0.011).Pairwise comparison showed that there was no significant difference in postoperative complications between the lean group and the normal group(p=0.100),and between the lean group and the overweight group(p=0.081).There was significant difference in postoperative complications between the normal group and the overweight group(p=0.010).The results of Mann-Whitney U test showed that the p values of psychosocial well-being,sexual well-being,physical well-being of chest wall,satisfaction with information,satisfaction with surgeon and satisfaction with medical team between immediate reconstruction group and delayed reconstruction group were0.265,0.154,0.390,0.730,0.182 and 0.165,respectively,indicating no significant difference between the two groups.There was significant difference in satisfaction with breast between immediate reconstruction group and delayed reconstruction group(p=0.034).Kruskal-Wallis H test was applied to explore the influencing factors of quality of life and satisfaction of patients after breast reconstruction in this breast center,and the results showed that there were significant differences in psychosocial well-being(p=0.013)and satisfaction with information(p=0.033)among different age groups.Pairwise comparison showed that scores of psychosocial well-being of patients lower than 30 years old were higher than that of patients between 31 and 40 years old(p=0.012),and scores of satisfaction with information of patients lower than30 years old were higher than that of both patients between 31 and 40 years old(p=0.016)and patients higher than 41 years old(p=0.014).Mann-Whitney U test showed that satisfaction with medical team of non-NAC group is higher than that of NAC group(p=0.026).Conclusion: The breast reconstruction and oncoplastic surgery in our center mainly consists of implant-based breast reconstruction,and the proportion of autologous breast reconstruction is small.Low incidence of postoperative complications of breast reconstruction was observed in this center,and over-weight patients are more likely to have postoperative complications.For the timing of surgery,we prefer to delayed breast reconstruction because the satisfaction of delayed reconstruction is higher than that of immediate reconstruction.We recommend boosting the education of psychosocial well-being and the popularization of disease-related information for patients over 30 years old.