Comparative UK Cross-sectional Study of Breast Cancer Patient-Reported Outcomes for Breast-Conserving Surgery and Immediate Reconstruction, Including Contribution to an International Collaborative Pilot Study

Introduction: Breast-conserving surgery (BCS) with adjuvant radiotherapy is oncologically comparable to mastectomy with immediate breast reconstruction (IBR) in treating breast cancer. This tertiary UK centre cross-sectional study compared BCS patient-reported outcomes with those of immediate implant-based (IBR) and free flap reconstruction (FFR), and included a contribution to a pilot international collaboration co-ordinated through the Organisation for Economic Cooperation and Development (OECD). Methods: Validated BREAST-Q (TM) 'satisfaction with breasts' modules were administered to 271 consecutive patients for six months after unilateral BCS, IBR, or FFR were conducted between June and October 2018. Risk adjustment data were collected on age, body mass index, smoking, radiotherapy, specimen weight, and tumour burden. Results: A total of 190 women returned completed questionnaires (131 BCS, 42 IBR, 17 FFR; 70% response rate). BCS scores (mean 68, standard deviation (SD) 23) were higher than those for IR overall (62, SD 23, p=0.04) and IBR (61, 24, p=0.03) but equivalent to those for FFR (66, SD 23, p=0.33). There was no significant difference in Q-Scores between the IBR and FFR groups (p=0.77). Scores were only minimally changed by risk adjustment and comparable to OECD mean international scores for IBR (61) and FFR (66). Conclusions: This is the first study to compare BCS and IR outcomes using a validated scale. BREAST-Q (TM) 'satisfaction with breasts' scores were comparable between BCS and FFR but significantly lower following IBR. (C) 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.