'The sooner the better' or 'too much too soon'? A pilot prospective longitudinal study to evaluate quality of life and body image following immediate latissimus dorsi breast reconstruction
© BioMed Central Ltd 2008
Published: 13 May 2008
Immediate breast reconstruction (BR) is currently advocated by the National Institute of Clinical Excellence on the basis of improved psychosocial outcomes with benefit of a single operative intervention. Tissue-based procedures are largely preferred due to cosmetic superiority, particularly in the context of postoperative radiotherapy (RT). The impact of this approach on quality of life (QoL), however, has never been fully evaluated. We present a pilot prospective longitudinal study that questions this practice.
Patients undergoing immediate latissimus dorsi (LD) BR, the most commonly offered reconstructive procedure in the UK, completed validated QoL questionnaires (EORTC C30+BR23/FACT B+4) together with the Body Image Scale preoperatively and at 3 months, 6 months, 12 months and 24 months post surgery. QoL and body image were compared in women undergoing extended (ELD) and implant-assisted (LDI) procedures ± postoperative RT.
Body image is superior following tissue-based reconstruction, but this difference is not reflected by superior QoL. Combining ELD with RT, however, has a profound effect on both body image and QoL. Surgeons should consider patientreported outcomes as well as cosmesis when recommending surgical options.
Funded by Allergan Aesthetics and United Bristol Healthcare Trust Charitable Trustees.