by Eltahir, Yassir; Krabbe-Timmerman, Irene S.; Sadok,
Nadia; Werker, Paul M. N.; de Bock, Geertruida H.
Plastic and Reconstructive
Surgery: May 2020 -
Volume 145 - Issue 5 - p 1109-1123
Background: This
review aimed to meta-analyze the quality of life of alloplastic versus
autologous breast reconstruction, when measured with the BREAST-Q.
Methods: An
electronic PubMed and EMBASE search was designed to find articles that compared
alloplastic versus autologous breast reconstruction using the BREAST-Q. Studies
that failed to present BREAST-Q scores and studies that did not compare
alloplastic versus autologous breast reconstruction were excluded. Two authors
independently extracted data from the included studies. A standardized data
collection form was used. Quality was assessed using the Newcastle-Ottawa
Scale. The mean difference and 95 percent confidence intervals between breast
reconstruction means were estimated for each BREAST-Q subscale. Forest plots
and the I2 statistic were used to assess heterogeneity and funnel plot
publication bias. The Z test was used to assess overall effects. Results: Two hundred eighty abstracts
were found; 10 articles were included. Autologous breast reconstruction scored
significantly higher in the five subscales than alloplastic breast
reconstruction. The Satisfaction with Breasts subscale indicated the greatest
difference, with a mean difference of 6.41 (95 percent CI, 3.58 to 9.24; I2 =
70 percent). The Satisfaction with Results subscale displayed a mean difference
of 5.52. The Sexual Well-Being subscale displayed a mean difference of 3.85.
The Psychosocial Well-Being subscale displayed a mean difference of 2.64. The
overall difference in physical well-being was significant, with high
heterogeneity (mean difference, 3.33; 95 percent CI, 0.18 to 6.48; I2 = 85).
Conclusion:
Autologous breast reconstruction had superior outcomes compared with
alloplastic breast reconstruction as measured by the BREAST-Q.
