Plastic Surgery Research Council
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PSRC 60th Annual Meeting
Program and Abstracts

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Comparison of Preoperative Quality of Life in Breast Reconstruction, Breast Aesthetic and Non-Breast Plastic Surgery Patients
Eliana F.R. Duraes, MD1, Paul Durand, MD1, Andrea Moreira, MD1, Joao Batista de Sousa, MD PhD2, Risal S. Djohan, MD, PhD1, James Zins, MD1, Steven Bernard, MD1, Graham S. Schwarz, MD1.
1Cleveland Clinic, Cleveland, OH, USA, 2Universidade de Brasilia, Brasilia, Brazil.

Purpose: A new breast cancer diagnosis imposes significant emotional and psychological duress; it is unclear how this may affect women’s breast specific quality of life (QOL). The purpose of this study was to assess the baseline QOL of breast cancer reconstruction patients, and compare it with QOL in women seeking plastic surgery consultation for cosmetic breast, and non-breast plastic surgical procedures.
Methods: From June 2012 through November 2013, reconstruction patients (group 1), aesthetic breast patients (group 2) and non-breast plastic surgery patients (group 3) answered validated preoperative Breast Q questionnaire modules. Univariate statistical analysis was performed using SPSS software.
Results: Patients from groups 1, 2 and 3 answered 182, 70 and 159 preoperative questionnaires respectively. Mean scores and standard deviation for each group are displayed in Table 1 by questionnaire domain.
There was no difference in breast satisfaction (p=0.081) and sexual well-being (p=0.780) between groups 1 and 3. Scores were lower in psychosocial well-being (p=0.025) and chest physical well-being (p=0.047) domains in these reconstructive patients compared with non-breast plastic surgical patients. Scores were higher in the abdominal physical well-being (p<0.001) domain when comparing these two groups. Aesthetic breast patients had lower scores in all domains compared to groups 1 and 3 (p<0.01).
Conclusion: Preoperatively, reconstruction patients had similar satisfaction with breasts and sexual well-being when compared to women being evaluated for non-breast plastic surgery, but lower psychological well-being and physical well-being of the chest. This may be due to psychological trauma of a breast cancer diagnosis, somatization and iatrogenic trauma related to the breast cancer workup.
Aesthetic breast patients had lower scores in all domains compared to breast reconstruction and non-breast plastic surgery patients.
Appropriate patient education and support services should be provided to women embarking on breast reconstructive and aesthetic surgery. Further studies are required to characterize the effect of preoperative QOL on postoperative patient reported outcomes.
Preoperative BreastQ Score per Domain: Expressed as Mean Score +/- Standard Deviation
DomainsGroup 1Group 2Group 3
Satisfaction with Breasts56.56±25.3328.3±22.2563.59±27.02
Psychosocial Well-being69.56±17.852.4±16.0575.77±22.61
Physical Well-being Chest79.19±15.7659.75±20.3484.19±16.97
Physical Well-being-Abdomen88.69±13.9771.09±22.8079.64±21.22
Sexual Well-being54.46±22.1537.65±19.8850.40±23.75


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