Patient-reported long-term outcomes after mastectomy, comparing the quilt technique to the conventional method.

BACKGROUND

The quilt technique results in a significant reduction of postoperative complications after mastectomy. However, concerns remain about the long-term effects on cosmetics, pain, and shoulder function after the quilt technique. This study evaluated long-term patient-reported cosmetic outcomes after mastectomy, comparing the quilt and conventional techniques.

METHODS

This retrospective multicentre evaluation study included 156 patients who underwent mastectomy between October 2018 and October 2022. Patients received quilting sutures (n = 81) or conventional closure (n = 75). The primary outcome was patient-reported cosmetic outcome, assessed using a 4-point Likert scale. Secondary outcomes were cosmetics evaluated by an expert panel, long-term shoulder function, and surgery-related pain.

RESULTS

In the study cohort, the median age was 65 ± 18 years. Unilateral mastectomy was performed in 131 (84.0 %) patients and bilateral mastectomy in 25 (16.0 %) patients. The median time after surgery was 38 ± 23 months. Long-term cosmetic outcomes were not significantly different between the quilted and non-quilted cohorts (p = 0.114): in the quilted cohort, 7.5 % of patients rated their cosmetic outcome as poor, 27.5 % as fair, 41.3 % as good, and 23.8 % as excellent, compared to the non-quilted cohort, 20.6 % rated their outcome as poor, 23.5 % as fair, 39.7 % as good, and 16.2 % as excellent. Expert panel assessment, long-term shoulder function, and surgery-related pain were comparable between the cohorts.

CONCLUSION

The quilt technique has no long-term deleterious effects regarding cosmetics, shoulder function, and surgery-related pain and can thus be applied safely in mastectomy wound closure. Concerns about long-term safety should be no argument for refraining from quilting.