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Expander prosthesis and DIEP flaps in delayed breast reconstruction : Sensibility, patient-reported outcome, and complications in a five-year randomised follow-up study

Tallroth, Linda LU orcid ; Mobargha, Nathalie ; Velander, Patrik LU ; Becker, Magnus LU orcid and Klasson, Stina LU (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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; ; ; and
organization
publishing date
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}},
}