1. Outcome of Quality of Life for Women Undergoing Autologous versus Alloplastic Breast Reconstruction following Mastectomy: A Systematic Review and Meta-Analysis
- Author
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Paul M N Werker, Geertruida H. de Bock, Yassir Eltahir, Irene S Krabbe-Timmerman, Nadia Sadok, Restoring Organ Function by Means of Regenerative Medicine (REGENERATE), Life Course Epidemiology (LCE), Damage and Repair in Cancer Development and Cancer Treatment (DARE), and Basic and Translational Research and Imaging Methodology Development in Groningen (BRIDGE)
- Subjects
Funnel plot ,SURGERY ,medicine.medical_treatment ,Breast surgery ,Breast Implants ,Mammaplasty ,Dentistry ,Breast Neoplasms ,030230 surgery ,Transplantation, Autologous ,RECOMMENDATIONS ,Surgical Flaps ,BODY-IMAGE ,03 medical and health sciences ,MORBIDITY ,0302 clinical medicine ,AGE ,medicine ,Humans ,Breast ,Patient Reported Outcome Measures ,skin and connective tissue diseases ,Mastectomy ,business.industry ,Publication bias ,CANCER ,Confidence interval ,Transplantation ,Treatment Outcome ,Patient Satisfaction ,030220 oncology & carcinogenesis ,Meta-analysis ,Quality of Life ,Female ,business ,Breast reconstruction - Abstract
Background: This review aimed to meta-analyze the quality of life of alloplastic versus autologous breast reconstruction, when measured with the BREAST-Q. Methods: An electronic PubMed and EMBASE search was designed to find articles that compared alloplastic versus autologous breast reconstruction using the BREAST-Q. Studies that failed to present BREAST-Q scores and studies that did not compare alloplastic versus autologous breast reconstruction were excluded. Two authors independently extracted data from the included studies. A standardized data collection form was used. Quality was assessed using the Newcastle-Ottawa Scale. The mean difference and 95 percent confidence intervals between breast reconstruction means were estimated for each BREAST-Q subscale. Forest plots and the I2statistic were used to assess heterogeneity and funnel plot publication bias. The Z test was used to assess overall effects. Results: Two hundred eighty abstracts were found; 10 articles were included. Autologous breast reconstruction scored significantly higher in the five subscales than alloplastic breast reconstruction. The Satisfaction with Breasts subscale indicated the greatest difference, with a mean difference of 6.41 (95 percent CI, 3.58 to 9.24; I2= 70 percent). The Satisfaction with Results subscale displayed a mean difference of 5.52. The Sexual Well-Being subscale displayed a mean difference of 3.85. The Psychosocial Well-Being subscale displayed a mean difference of 2.64. The overall difference in physical well-being was significant, with high heterogeneity (mean difference, 3.33; 95 percent CI, 0.18 to 6.48; I2= 85). Conclusion: Autologous breast reconstruction had superior outcomes compared with alloplastic breast reconstruction as measured by the BREAST-Q.
- Published
- 2020