Analysis of outcomes and patient’s satisfaction following monolateral and bilateral mastectomy using BREAST-Q

Background: Breast reconstruction plays an important role in improving the quality of life of patients with breast cancer. The aim of this study is to verify if there is a difference in patient’s satisfaction and in body perception following monolateral and bilateral mastectomy with breast reconstruction. Methods: The study population were 144 women who had undergone mastectomy and breast reconstruction at our hospital between 2005 and 2016. They filled out BREAST-Q post-operative module after almost 1 year from breast reconstruction. We administered the questionnaire electronically almost 1 year after surgery for each procedure. Results: This cross-sectional study compared two cohorts in which 121 women underwent monolateral mastectomy and breast reconstruction with or without contralateral adjustment and 23 women underwent bilateral mastectomy and breast reconstruction. After reconstruction procedures, patients that underwent bilateral mastectomy were more satisfied than monolateral mastectomy group in satisfaction with appearance of breast (P < 0.001). In the comparison between monolateral and bilateral nipple-sparing mastectomy groups, the bilateral nipple mastectomy group was more satisfied in satisfaction with appearance of breast (P = 0.005) and physical well-being (P = 0.003). In the comparison between bilateral nipple-sparing mastectomy and no nipple-sparing mastectomy, the first group was more satisfied in psychosocial well-being (P = 0.03) and physical well-being (P = 0.03). Conclusions: Bilateral mastectomy has a favorable post-operative surgical cosmetic outcome with a better patient’s body image perception and bigger post-operative satisfaction. This is the first study that compares monolateral and bilateral mastectomy using a validated patient-reported outcome measure. Level of Evidence: Level III, risk/prognostic study. © 2017, Springer-Verlag GmbH Germany, part of Springer Nature.