Preoperative expectations and quality of life after breast reconstruction: Finnish validation of the BREAST-Q Reconstruction Expectations module

Abstract

Background and Aims: Patient expectations can influence satisfaction and health-related quality of life (HRQL) after breast reconstruction. The aim of this study was to evaluate both patient expectations before breast reconstruction and HRQL after a 1-year follow-up. Methods: A cohort study was performed on patients awaiting delayed breast reconstruction at Helsinki University Hospital in April 2020. The BREAST-Q Reconstruction Expectations module was translated into Finnish following accepted guidelines for preoperative assessment of expectations. One-year outcomes were assessed using the BREAST-Q Reconstruction module. Correlation analyses were performed to evaluate associations between expectations and postoperative HRQL. Results: Of 145 patients approached, 57 patients (39%) participated. Median preoperative age was 54 years (interquartile range (IQR) = 47–63). Expectations for coping were high (median = 100, IQR = 68–100). At 1 year, appearance, shape, and clothing fit were expected to return to near normal (median = 69, IQR = 53–91), and donor site appearance and function were expected to normalize (median = 6, IQR = 5–7). At 1 year, 38 patients (67%) completed follow-up. Median scores (IQR) were psychosocial well-being 62 (48–80), satisfaction with breasts 60 (47–76), physical well-being of the chest 85 (64–92), and physical well-being of the abdomen 72 (62–81), indicating generally favorable outcomes. High expectations for coping were associated with better psychosocial well-being postoperatively. In addition, patients expecting more pain reported lower physical well-being of the chest at 1 year. Conclusions: Breast cancer patients reported high expectations regarding the upcoming breast reconstruction, and the HRQL after a 1-year follow-up reflected attainment of these goals. Clinical trial registration: N/A.