Patients with Abdominal-based Free Flap Breast Reconstruction a Decade after Surgery - A Comprehensive Long-term Follow-up Study

Publication date: Available online 28 June 2018
Source:Journal of Plastic, Reconstructive & Aesthetic Surgery
Author(s): Tianyi Liu, Christoffer Freijs, Holger J Klein, Anna Feinbaum, Andreas Svee, Andres Rodrigues Lorenzo, Anders Liss, Rafael Acosta, Maria Mani
BackgroundAbdominal-based free flap breast reconstruction has increasingly become the gold standard, however long-term evidence of aesthetic outcome and quality of life is lacking. Our study aims to gain an overview of patients with abdominal-based free flap breast reconstructions in a long-term perspective.MethodsSeventy-five patients who received abdominal-based free flap breast reconstructions between 2000-2007 in Uppsala, Sweden were invited back for photographs, 3D imaging and questionnaires. A retrospective chart review was conducted. Patient satisfaction with appearance and quality of life were assessed using the Breast-Q questionnaire. A layman panel and a professional panel rated the aesthetic appearance of the reconstructed breast from photographs and 3D images.ResultsFifty-five patients participated with a mean age of 52±8 years at the time of reconstruction and a mean follow-up time of 11.4±1.8 years completed the study. The majority of the patients had received unilateral (83%), delayed reconstructions (73%) with prior radiation (55%). There were 53 patients with DIEP flaps, one with free TRAM flap and one with SIEA flap. Overall patient satisfaction and quality of life were comparable to normative values of women without breast cancer (p<0.001). There was a high level of agreement for the aesthetic results of the reconstructions between patient, professionals and layman panels (0.89 ICC, 95% CI: 0.83 - 0.93).ConclusionAbdominal-based free flap reconstructions were effective in achieving a lasting positive aesthetic result and a high quality of life in patients a decade after surgery.