EVALUATION OF AESTHETIC AND QUALITY OF LIFE RESULTS AFTER IMMEDIATE BREAST RECONSTRUCTION WITH ANATOMICAL FORM-STABLE IMPLANTS AND CONCOMITANT CONTRALATERAL SYMMETRIZATION

Immediate breast reconstruction (IBR) with implants is the most widely form of breast reconstruction after mastectomy. Recent emphasis on women’s quality of life following breast cancer treatment has drawn attention to the importance of aesthetic outcomes. Objective: Evaluate aesthetic and quality of life results in breast cancer patients undergoing mastectomy with IBR using implants and contralateral symmetrization. Methods: 129 breast cancer patients were included in this cross-sectional multicentric study; 94 (72.8%) underwent mastectomy with IBR using anatomical implants and contralateral symmetrization, and 35 (27,1 %) to mastectomy alone. Aesthetic results were evaluated by 3 different methods: the patient’s self-report, assessment of 4 specialists (two breast surgeons and two plastic surgeons) using the Garbay scale, and the BCCT.core software. Quality of life was evaluated through 2 questionnaires: a generic self-report SF-36 and a specific patient-reported outcome instrument breast reconstruction postoperative module? Breast-Q. Results: Patients in the IBR group had a significantly higher proportion of excellent aesthetic results comparing with the software and by the specialists (p<0.001). There was no significant difference in the comparison between software and specialist’s evaluation. Multifactorial analysis showed that age >70 and radiotherapy were significant risk factors for poor aesthetic outcomes after IBR with implants. Considering quality of life using SF-36 and Breast-Q questionnaires, there was a significant difference (p<0,05) between the groups, with higher values observed in the IBR group. Conclusions: IBR with implants and contralateral symmetrization had a positive impact in the quality of life, when comparing with mastectomy alone. Excellent and good aesthetic results were more frequent in patient’s evaluation than by the software and specialists. In addition, some clinical conditions like age and radiotherapy can be considered as risky factors for poor aesthetic outcomes in IBR with implants. So, IBR with implants showed satisfactory outcomes when evaluated by subjective and objective methods.