Evaluation of quality of life after breast reconstruction using an autologous latissimus dorsi myocutaneous flap

Abstract 

Aims

To evaluate the patients’ satisfaction with breast reconstruction using the autologous latissimus dorsi technique and the impact of the procedure on the quality of life and body image of women who had mastectomy for breast cancer.

Methods

A retrospective transversal study was conducted at the Georges François Leclerc Cancer Care Center in Dijon, France. From 1990 to 2008, 193 women underwent reconstruction (RW), among these, 141 were matched for age at diagnosis and the date of the mastectomy with women who did not undergo reconstruction (NRW) identified using data from the Côte d’Or breast cancer registry. Questionnaires concerning quality of life, body image and satisfaction (MBROS-S, MBROS-BI, EORTC QLQ-C30, EORTC QLQ-BR23) were sent through the post following surgery.

Results

The overall response rate was 77% and the mean (MBROS-S) satisfaction score was 3.36. The quality of life (EORTC QLQ-C30, EORTC QLQ-BR23) in RW was no better than that in NRW, but body image was better (p = 0.0247) especially before 60 years (p = 0.0192), in obese patients (p = 0.03) and when the breasts of RW were heavy (p = 0.0197). Moreover, when the time from the mastectomy was less than 4 years, body image (p = 0.0008) and the sexual activity score (p = 0.0078) were higher in RW.

Conclusions

The level of satisfaction was higher in RW, and breast reconstruction made a strong contribution in terms of improvement in body image. A prospective study to evaluate quality of life in the long term is now necessary.

Keywords: Breast reconstruction, Cancer, Quality of life