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Breast reconstructi...
Breast reconstruction timing and modality in context : A cross-sectional study in Uppsala, Maastricht, and Rome
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- Smeele, Hansje P. (författare)
- Maastricht Univ, Med Ctr, Dept Plast Reconstruct & Hand Surg, GROW Sch Oncol & Dev Biol, Maastricht, Netherlands.
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- Bijkerk, Ennie (författare)
- Maastricht Univ, Med Ctr, Dept Plast Reconstruct & Hand Surg, GROW Sch Oncol & Dev Biol, Maastricht, Netherlands.
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- van Rooij, Joep A. F. (författare)
- Maastricht Univ, Med Ctr, Dept Plast Reconstruct & Hand Surg, GROW Sch Oncol & Dev Biol, Maastricht, Netherlands.
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- Mani, Maria R. (författare)
- Univ Uppsala Hosp, Dept Plast & Reconstruct Surg, Uppsala, Sweden
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- Lindell Jonsson, Eva (författare)
- Univ Uppsala Hosp, Dept Plast & Reconstruct Surg, Uppsala, Sweden
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- Salgarello, Marzia (författare)
- Fdn Policlin Univ A Gemelli IRCSS, Dept Plast Surg, Rome, Italy.
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- Barone Adesi, Liliana (författare)
- Fdn Policlin Univ A Gemelli IRCSS, Dept Plast Surg, Rome, Italy.
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- van Kuijk, Sander M. J. (författare)
- Maastricht Univ, Med Ctr, Dept Clin Epidemiol & Med Technol Assessment, Maastricht, Netherlands.
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- van der Hulst, René R. W. J. (författare)
- Maastricht Univ, Med Ctr, Dept Plast Reconstruct & Hand Surg, GROW Sch Oncol & Dev Biol, Maastricht, Netherlands.
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- Tuinder, Stefania M. H. (författare)
- Maastricht Univ, Med Ctr, Dept Plast Reconstruct & Hand Surg, GROW Sch Oncol & Dev Biol, Maastricht, Netherlands.
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Maastricht Univ, Med Ctr, Dept Plast Reconstruct & Hand Surg, GROW Sch Oncol & Dev Biol, Maastricht, Netherlands Univ Uppsala Hosp, Dept Plast & Reconstruct Surg, Uppsala, Sweden (creator_code:org_t)
- Springer, 2023
- 2023
- Engelska.
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Ingår i: European journal of plastic surgery. - : Springer. - 0930-343X .- 1435-0130. ; 47:1
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- BackgroundWith the development and refinement of techniques most mastectomy patients nowadays are candidates for breast reconstruction. No one surgical technique fits all, however. Treatment choices are driven by patient characteristics and preferences, alongside policy and operational factors. These, in turn, might be expected to differ on several levels of aggregation, for example, countries, regions, and hospitals. The aim of this study was to compare choices for breast reconstruction timing and modality in Uppsala (Sweden), Maastricht (the Netherlands), and Rome (Italy).MethodsIn this cross-sectional study, patients presenting for first-time post-mastectomy breast reconstruction in three teaching hospitals were included. The primary study outcomes were breast reconstruction timing and modality. Covariables were body habitus (i.e., body mass index, waist circumference, and mastectomy weight), health-related quality of life assessed with the BREAST-Q Reconstruction module, patient preferences assessed with a self-constructed questionnaire, and shared decision making assessed with the CollaboRATE questionnaire. Statistical tests were used to compare data across study sites.ResultsSixty-six participants were included. The most common choices for breast reconstruction timing and modality were delayed DIEP flaps in Uppsala (53%), immediate DIEP flaps in Maastricht (44%), and immediate prepectoral implants in Rome (92%). Participants in Rome were much slenderer than participants in Uppsala and Maastricht (mean body mass index 21.6, 26.2, and 26.3 kg/m2, respectively; p < 0.05). Participants in Uppsala and Maastricht highly valued material used for the reconstruction; participants in Rome were significantly more concerned with complications, scars, and recovery duration associated with the reconstruction.ConclusionsThis study shows large differences in choices for breast reconstruction timing and modality in Uppsala, Maastricht, and Rome. Possible reasons for the observed variation include differences in patient characteristics, patient preferences, reconstructive techniques available, and reimbursement.Level of evidenceLevel IV, Therapeutic study.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
Nyckelord
- Mastectomy
- Breast reconstruction
- Decision making
- Patient selection
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Smeele, Hansje P ...
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Bijkerk, Ennie
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van Rooij, Joep ...
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Mani, Maria R.
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Lindell Jonsson, ...
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Salgarello, Marz ...
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Barone Adesi, Li ...
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van Kuijk, Sande ...
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van der Hulst, R ...
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Tuinder, Stefani ...
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