Patient-reported Outcomes Utilizing the BREAST-Q Questionnaire After Breast-Conserving Surgery With and Without Oncoplastic Breast Surgery: A Systematic Review and Meta-analysis (2024)

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Volume 44 Issue 11 November 2024
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Adriana C Panayi, MD

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Samuel Knoedler

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Leonard Knoedler, MD

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Christian Tapking, MD, MMS

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Gabriel Hundeshagen, MD, MMS

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Yannick F Diehm, MD, MMS

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Sebastian Fischer, MD, MHBA

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Ulrich Kneser, MD

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Valentin Haug, MD

Corresponding Author: Dr Valentin Haug, Department of Hand, Plastic and Reconstructive Surgery, Microsurgery, BG Trauma Center Ludwigshafen, University of Heidelberg, Ludwig-Gutmann-Str. 13; 67071 Ludwigshafen am Rhein, Germany. Email: vfm.haug@gmail.com

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Aesthetic Surgery Journal, Volume 44, Issue 11, November 2024, Pages NP778–NP789, https://doi.org/10.1093/asj/sjae002

Published:

21 August 2024

Article history

Editorial decision:

20 December 2023

Corrected and typeset:

21 August 2024

Published:

21 August 2024

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    Adriana C Panayi, Samuel Knoedler, Leonard Knoedler, Christian Tapking, Gabriel Hundeshagen, Yannick F Diehm, Sebastian Fischer, Oliver C Thamm, Ulrich Kneser, Valentin Haug, Patient-reported Outcomes Utilizing the BREAST-Q Questionnaire After Breast-Conserving Surgery With and Without Oncoplastic Breast Surgery: A Systematic Review and Meta-analysis, Aesthetic Surgery Journal, Volume 44, Issue 11, November 2024, Pages NP778–NP789, https://doi.org/10.1093/asj/sjae002

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Abstract

Oncoplastic breast surgery (OBS) arose to decrease the deformity following breast-conserving surgery (BCS) for breast cancer. In this meta-analysis (MA), we pool BREAST-Q questionnaire data to compare quality of life (QOL) in breast cancer patients who received BCS alone or in combination with level I or II oncoplastic breast surgery (BCS + OBS). All relevant databases were searched following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and QUOROM (Quality of Reporting of Meta-Analyses) guidelines. All prospective or retrospective studies with a BCS or BCS + OBS cohort that reported QOL as assessed with the BREAST-Q questionnaire were eligible. Fifty-five studies (75 distinct patient cohorts; 11,186 patients) were included in the MA, with 12 studies reporting both preoperative and postoperative values and eligible for a pair-wise MA. The pair-wise MA showed a significant postoperative improvement in the overall satisfaction with the breast (mean difference [MD] +8.0%, P = .003) and in the psychosocial well-being (MD +9.2%, 3.5-14.8, P = .001) of the entire cohort (BCS and BCS + OBS). A subgroup MA of proportions highlighted a superiority of BCS + OBS to BCS in overall satisfaction with the breast (72.0%, 68.0-76.1, vs 62.9%, 58.3-67.5; P = .02) and psychosocial well-being (78.9%, 71.5-86.4, vs 73.3%, 67.3-76.5, P = .0001). A leave-1-out sensitivity analysis confirmed the results of the pair-wise MA and the MA of proportions. Oncoplastic breast surgery effectively improves QOL and patient satisfaction based on the patient-reported outcomes assessed with the BREAST-Q questionnaire. The improvements were associated with acceptable complication rates, further supporting BCS followed by OBS when mastectomy would otherwise be necessary.

Level of Evidence: 3

Patient-reported Outcomes Utilizing the BREAST-Q Questionnaire After Breast-Conserving Surgery With and Without Oncoplastic Breast Surgery: A Systematic Review and Meta-analysis (7)

© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/pages/standard-publication-reuse-rights)

Subject

Aesthetic Breast Reconstruction

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Review Article

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