Garment-related patient-reported outcomes: a longitudinal pre-post comparison of autologous versus implant-based breast reconstruction.

PURPOSE: Quantitative and qualitative methods have been used to explore breast cancer survivors' experience with bras, but there are limited studies using validated patient-reported outcome instruments. While BREAST-Q includes garment-related items, analyses of these items are rarely reported. This study aims to assess pre- and post-reconstruction changes in the garment-related items of BREAST-Q for patients who underwent autologous and implant-based breast reconstruction.

METHOD: This longitudinal study included 81 patients who underwent autologous or implant-based breast reconstruction. Patients completed the BREAST-Q Breast Cancer modules, Appearance Schemas Inventory-Revised (ASI-R), and Body Image Scale (BIS) both pre-mastectomy and post-reconstruction. Robust regression was used to investigate associations between preoperative characteristics (age, BMI, ASI-R, surgery type) and postoperative patient-reported outcomes.

RESULTS

Positive changes were observed in all garment-related BREAST-Q outcomes from pre-to post-reconstruction, regardless of reconstruction type, with greater improvements in the autologous reconstruction group. Regression analysis showed mixed associations between preoperative characteristics and postoperative garment-related outcomes. While BMI and ASI-R were not significant predictors, age and surgery type influenced satisfaction with "how you look in the mirror clothed", with autologous reconstruction associated with higher satisfaction.

CONCLUSIONS

The study found that garment experiences improved post-reconstruction for breast cancer patients. However, the limited garment-related items in BREAST-Q underscore the need for a dedicated, validated tool to better assess these experiences.