The impact of delayed wound healing on patient-reported outcomes after breast cancer surgery.

PURPOSE: Postoperative complications after breast cancer surgery may be associated with decreased quality of life. It remains unclear whether oncoplastic breast-conserving surgery or mastectomy with reconstruction lead to more postoperative complications than conventional breast surgery (CBS). As delayed wound healing (DWH) is one of the most frequent minor complications, we sought to investigate the significance of DWH for patient-reported outcomes after oncoplastic, reconstructive, and CBS. METHODS: Our study is a retrospective cohort study of consecutive patients with stage I-II breast cancer who underwent oncoplastic or CBS performed by three breast surgeons at a single tertiary referral hospital from June 2011 until May 2019. Patient-reported outcomes were evaluated postoperatively using the BREAST-Q questionnaire. Comparisons were made between patients with and without DWH. RESULTS: A total of 229 patients who met the inclusion criteria and 28 (12%) of them developed DWH, 27/158 (17%) in the oncoplastic breast-conserving surgery and reconstruction group and 1/71 (1%) in the CBS group. The mean time from surgery to BREAST-Q assessment was comparable in both groups (29 months in the DWH vs. 33 months in the normal wound healing group). No statistically significant difference for any BREAST-Q scale was detected between patients with and without DWH. This includes physical (p = 0.183), psychosocial (p = 0.489), sexual well-being (p = 0.895), and satisfaction with breasts (p = 0.068). CONCLUSION: Our study confirms that oncoplastic breast-conserving surgery and mastectomy with reconstruction lead to significantly more DWH than CBS. However, neither quality of life nor patient-reported outcomes following state-of-the-art reconstructive or oncoplastic breast-conserving surgery at a specialized center seem to be compromised.

Brustrekonstruktion ­ der Einfluss des Verfahrens auf die Lebensqualität.

English Breast cancer and the surgical procedures associated with it have a major impact on the quality of life of affected patients. Research shows that the loss of the breast and the associated change in body image have a major impact on the female self-image for many women. This has a strong negative impact on the quality of life of those affected. With modern clinical outcome research including treatment results from the patient's perspective in the form of patient-reported outcome measures (PROMs), the satisfaction and quality of life of those affected can be measured, analysed and compared. This review examines the extent to which breast reconstruction improves the quality of life for many women and how the different reconstruction methods vary in their impact on quality of life and satisfaction. In addition, the review discusses the importance of standardised recording and analysis of PROMs in combination with objective clinical data and their integration into the treatment process, and it demonstrates implementation options. Such systematic recording of PROMs enables the creation of databases and registers, the evaluation of which provides information that can be used for scientific and clinical purposes. Based on these research results, prognostic models can be created and treatment results can be examined in comparative studies facilitating clinical decision-making and quality controls.

Capturing Plastic Surgery on Film-Making Reconstruction Visible.

The Swiss Plastic Surgery Association (https://plasticsurgery.ch/en/) decided to produce a corporate video to illustrate the concept of "plastic surgery of confidence" to the public. We show the diversity of specializations and the vast range of tasks that surgeons passionately handle day in and day out. We wanted to convey 2 main messages: first, that plastic surgery is more than just cosmetic surgery, and second, that plastic surgery in Switzerland is synonymous with quality and confidence. We selected 17 topics that we felt had good filmic potential and would best explain to the public what plastic surgery is about. This included the selection of appropriate patients, experts, and locations from all over the country. We thought it crucial to show the initial preoperative situation, as only in this case would the achievement of reconstruction be evident and comprehensive to the layman audience. The actual production was filmed in 5 different locations and took 5 days of shooting. We recorded 17 surgeons, 9 patients, and about 30 voluntary background actors. From 23 hours of footage, we created a 7 minute, 22 second corporate video, recorded in 3 of the Swiss national languages. The video was presented to the public online in June 2016, on the same day as the National Open Day of Plastic Surgery in Switzerland. The video is available online. We evaluated the impact of the video using a questionnaire for lay people and observed that it could substantially improve the perception of our specialty, especially regarding the reconstructive aspect. We feel that a freely available corporate video is a very useful means to promote plastic surgery and help patients better understand what it is all about.