1124 – The post-mastectomy breast reconstruction outcomes: are we doing great from the patients’ perspective?

Abstract

Introduction: The psychological benefits and oncologic safety of postmastectomy breast reconstruction (BR) are well
established. Outcome evaluation is an essential step to understand the true benefit of BR regarding self-esteem, sexual
function, and satisfaction. This should be the a key question among surgeons: Are we doing great from a patient’s perspective? How should this be measured?
Objective: To provide a new perspective in this field by introducing an original appreciation method.
Methods: The survey included 23 patients who underwent postmastectomy BR from 2017–2020 at Oswaldo Cruz University
Hospital, attended a consultation between October–December 2020, and completed questionnaires. To assess patient satisfaction, an analytical scale adapted from customer satisfaction scales were used, and questions about the process were
asked. The EORTC-BRECON23 questionnaire was administered to measure sexual dysfunction and general satisfaction,
and score ranged between 0–100.
Results: A total of 22 BRs were analyzed: 73% were implant-based and 27% were expander/implant-based. Modified radical mastectomies accounted for 50% of the procedures. The average age was 45 years. Tumors were predominantly T1/T2
(64%); radiotherapy was used in 23% of cases. Complications occurred in 13.6%. The average satisfaction score was 7.3/10.
The EORTC QLQ-BRECON23 general satisfaction was mild/high in 55%, no/low in 27%, and low/mild in 18%. Identical
percentages were reported for sexual dysfunction. Regarding patient perception, of 22 women, 20 would recommend the
procedure, 16 achieved expected results, and 19 agreed with the proposed results.
Conclusion: Understanding BR patient satisfaction requires measuring it, especially within Brazil’s public healthcare
reality. High satisfaction was observed among patients, although ideally it should be higher. Over half of the patients had
sexual dysfunction impacting self-esteem; however, there was conformity between expectations and outcomes. The small
sample size limits establishing causality relations. Further studies on patients’ perspectives are necessary to enhance
understanding of BR patterns and improve outcomes.
Ethics: Research Ethics Committee Approval (CAAE 34899720.3.0000.5192).