Expander prosthesis and DIEP flaps in delayed breast reconstruction : Sensibility, patient-reported outcome, and complications in a five-year randomised follow-up study
(2023) In Journal of Plastic Surgery and Hand Surgery 58. p.101-109- Abstract
Breast reconstruction is a given choice for many women following mastectomy. There are a multitude of methods available today, and thus, comparative studies are essential to match patients with suitable methods. The aim of this study was to compare 5-year outcomes following delayed breast reconstruction with expander prosthesis (EP) and with deep inferior epigastric perforator (DIEP) flaps. Seventy-three patients, previously randomised to either a permanent EP or a DIEP flap breast reconstruction, were invited for a 5-year follow-up. Assessments included symmetry measurements, breast sensibility with Semmes-Weinstein monofilaments and patient-reported outcome (PRO) with the BREAST-Q. Complications within the first 5 postoperative years... (More)
Breast reconstruction is a given choice for many women following mastectomy. There are a multitude of methods available today, and thus, comparative studies are essential to match patients with suitable methods. The aim of this study was to compare 5-year outcomes following delayed breast reconstruction with expander prosthesis (EP) and with deep inferior epigastric perforator (DIEP) flaps. Seventy-three patients, previously randomised to either a permanent EP or a DIEP flap breast reconstruction, were invited for a 5-year follow-up. Assessments included symmetry measurements, breast sensibility with Semmes-Weinstein monofilaments and patient-reported outcome (PRO) with the BREAST-Q. Complications within the first 5 postoperative years were recorded. Additionally, BREAST-Q questionnaires were collected from non-randomised patients with an EP breast reconstruction. Between 2019 and 2022, 65 patients completed the follow-ups. Symmetry and PRO were significantly higher in the DIEP flap group. However, EP-reconstructed breasts were significantly more sensate and demonstrated areas with protective sensibility, unlike the DIEP flap breasts. The overall complication rates were comparable between the two groups (p = 0.27). Regression analysis identified body mass index as a risk factor for reoperation in general anaesthesia and for wound infection. No significant differences were found in a comparison of the randomised and the non-randomised EP groups' BREAST-Q results. This randomised 5-year follow-up study found PRO to be favourable following a DIEP flap reconstruction and sensibility to be better in EP reconstructions. The complication rates were comparable; however, longer follow-ups are warranted to cover the complete lifespans of the two breast reconstruction methods.
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- author
- Tallroth, Linda LU ; Mobargha, Nathalie ; Velander, Patrik LU ; Becker, Magnus LU and Klasson, Stina LU
- organization
- publishing date
- 2023-09-22
- type
- Contribution to journal
- publication status
- published
- subject
- in
- Journal of Plastic Surgery and Hand Surgery
- volume
- 58
- pages
- 9 pages
- publisher
- Taylor & Francis
- external identifiers
-
- pmid:37747180
- scopus:85172425464
- ISSN
- 2000-656X
- DOI
- 10.2340/jphs.v58.13477
- language
- English
- LU publication?
- yes
- id
- d65e1a9c-e9c3-4155-89cb-c3282d876aff
- date added to LUP
- 2023-12-18 09:09:41
- date last changed
- 2024-04-16 21:20:13
@article{d65e1a9c-e9c3-4155-89cb-c3282d876aff, abstract = {{<p>Breast reconstruction is a given choice for many women following mastectomy. There are a multitude of methods available today, and thus, comparative studies are essential to match patients with suitable methods. The aim of this study was to compare 5-year outcomes following delayed breast reconstruction with expander prosthesis (EP) and with deep inferior epigastric perforator (DIEP) flaps. Seventy-three patients, previously randomised to either a permanent EP or a DIEP flap breast reconstruction, were invited for a 5-year follow-up. Assessments included symmetry measurements, breast sensibility with Semmes-Weinstein monofilaments and patient-reported outcome (PRO) with the BREAST-Q. Complications within the first 5 postoperative years were recorded. Additionally, BREAST-Q questionnaires were collected from non-randomised patients with an EP breast reconstruction. Between 2019 and 2022, 65 patients completed the follow-ups. Symmetry and PRO were significantly higher in the DIEP flap group. However, EP-reconstructed breasts were significantly more sensate and demonstrated areas with protective sensibility, unlike the DIEP flap breasts. The overall complication rates were comparable between the two groups (p = 0.27). Regression analysis identified body mass index as a risk factor for reoperation in general anaesthesia and for wound infection. No significant differences were found in a comparison of the randomised and the non-randomised EP groups' BREAST-Q results. This randomised 5-year follow-up study found PRO to be favourable following a DIEP flap reconstruction and sensibility to be better in EP reconstructions. The complication rates were comparable; however, longer follow-ups are warranted to cover the complete lifespans of the two breast reconstruction methods.</p>}}, author = {{Tallroth, Linda and Mobargha, Nathalie and Velander, Patrik and Becker, Magnus and Klasson, Stina}}, issn = {{2000-656X}}, language = {{eng}}, month = {{09}}, pages = {{101--109}}, publisher = {{Taylor & Francis}}, series = {{Journal of Plastic Surgery and Hand Surgery}}, title = {{Expander prosthesis and DIEP flaps in delayed breast reconstruction : Sensibility, patient-reported outcome, and complications in a five-year randomised follow-up study}}, url = {{http://dx.doi.org/10.2340/jphs.v58.13477}}, doi = {{10.2340/jphs.v58.13477}}, volume = {{58}}, year = {{2023}}, }