Patients’ impression of breast symmetry following unilateral or bilateral immediate to implant reconstruction, and their tendency toward repeat surgeries

Tjasink, Gareth N
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The aim of this study was to compare patient-reported outcomes in female breast cancer patients who opted for contralateral prophylactic mastectomy with bilateral immediate implant-based reconstruction, or who had unilateral skin–sparing mastectomy with an immediate prosthetic reconstruction, in terms of patients’ impression of breast symmetry and satisfaction with their breasts, as well as the number of repeat surgeries these patients underwent for cosmetic purposes. The study utilised an established, valid, and reliable patient-reported outcome tool - the BREAST-Q - and employed a descriptive cross-sectional questionnaire-based study design. The question posed was whether immediate reconstruction following an elective bilateral mastectomy, while having little oncological benefit, may have other benefits including increased patient satisfaction and/or a superior cosmetic result compared to patients who opted for a unilateral implant-based reconstruction. The results of this study do not support this assumption. They, instead, indicate that the satisfaction levels were comparable and not as obviously disparate as predicted and the tendency to repeat surgeries for cosmetic reasons was parallel among the two groups. However, due to small and uneven sample sizes the findings of this research are not statistically conclusive and further research is necessary to corroborate the results.
A Dissertation submitted in fulfilment of the requirements for the degree of Master of Medicine (MMED) to the Faculty of Science, University of the Witwatersrand, Johannesburg, 2022