A systematic review of factors affecting quality of life after postmastectomy breast reconstruction in women with breast cancer

Objective The aim of this study is to present a broader perspective of factors affecting the quality of life after postmastectomy breast reconstruction in women with breast cancer by considering these patients' self-reported outcomes. Methods The search was performed from 29 March to 19 April 2019, on the following databases: PsycInfo; Web of Science Core Collection, Current Contents Connect, Derwent Innovations Index, KCI-Korean Journal Database, Russian Science Citation Index, SciELO Citation Index, and MEDLINE. The studies were included if they identified factors affecting self-reported quality of life after breast reconstruction, in women with breast cancer. Results One hundred and twenty-two records were identified. After quality assessment, 44 studies were included for qualitative synthesis. This review comprised a total of 16 683 women who underwent breast reconstruction. The results identified a broad collection of 32 empirically based variables associated with several domains of quality of life. These variables were grouped into four categories: (a) surgical, (b) clinical, (c) psychosocial, and (d) sociodemographic variables. Conclusions This systematic review goes beyond surgical factors of morbidity and uses patient-reported outcomes to scope wider issues that influence quality of life, such as psychosocial and sociodemographic variables. It sustains the need to adopt a more holistic approach and advises the consideration of preoperative psychosocial factors to better understand these patients' quality of life after breast reconstruction and to implement future preventive measures.