==== Front Int J Clin Oncol Int J Clin Oncol International Journal of Clinical Oncology 1341-9625 1437-7772 Springer Nature Singapore Singapore 37160493 2347 10.1007/s10147-023-02347-5 Invited Review Article Trends and issues in clinical research on satisfaction and quality of life after mastectomy and breast reconstruction: a 5-year scoping review http://orcid.org/0000-0003-1310-6560 Saiga Miho gmd20076@s.okayama-u.ac.jp 1 Nakagiri Ryoko 1 Mukai Yuko 2 Matsumoto Hiroshi 3 Kimata Yoshihiro 3 1 grid.412342.2 0000 0004 0631 9477 Department of Plastic Surgery, Okayama University Hospital, 2-5-1, Shikata-cho, Kita-ku, Okayama City Okayama, 700-8558 Japan 2 grid.416813.9 0000 0004 1773 983X Department of Plastic Surgery, Okayama Rosai Hospital, Okayama, Japan 3 grid.261356.5 0000 0001 1302 4472 Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan 9 5 2023 9 5 2023 2023 28 7 847859 24 2 2023 20 4 2023 © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/ Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. Breast reconstruction (BR) aims to improve the satisfaction and quality of life (QOL) of breast cancer survivors. Clinical studies using patient-reported outcomes (PROs) can therefore provide relevant information to the patients and support decision-making. This scoping review was conducted to analyze recent trends in world regions, methods used, and factors investigated. The literature search was conducted in August 2022. Databases of PubMed, MEDLINE, and CINAHL were searched for relevant English-language studies published from 2017 to 2022. Studies involving women with breast cancer who underwent BR after mastectomy and investigated PROs after BR using BR-specific scales were included. Data on the country, publication year, study design, PRO measures (PROMs) used, time points of surveys, and research themes were collected. In total, 147 articles met the inclusion criteria. BREAST-Q was the most widely used, contributing to the increase in the number and diversification of studies in this area. Such research has been conducted mainly in North America and Europe and is still developing in Asia and other regions. The research themes involved a wide range of clinical and patient factors in addition to surgery, which could be influenced by research methods, time since surgery, and even cultural differences. Recent BR-specific PROMs have led to a worldwide development of research on factors that affect satisfaction and QOL after BR. PRO after BR may be influenced by local cultural and social features, and it would be necessary to accumulate data in each region to draw clinically useful conclusion. Keywords Patient-reported outcomes Breast reconstruction Breast cancer Quality of life Satisfaction http://dx.doi.org/10.13039/100018736 Kaken Pharmaceutical 22K16988 Saiga Miho Okayama University Female Staff Support GrantOkayama UniversityOpen access funding provided by Okayama University. issue-copyright-statement© Japan Society of Clinical Oncology 2023 ==== Body pmcIntroduction Currently, surgical strategies for breast cancer are becoming increasingly diverse, including the development of breast reconstruction (BR) techniques and the widespread of prophylactic mastectomy. BR aims to improve the body image and quality of life (QOL) of breast cancer survivors; however, patients must choose the best treatment for themselves, considering implant-specific issues, donor-site sacrifice, psychological burden, costs, and physical and social rehabilitation. Thus, to help patients make a choice suitable for their situation and preferences, information on the advantages and disadvantages of each option in terms of QOL, complications, and aesthetic outcomes is necessary. Outcome evaluation using patient-reported outcomes (PROs) is helpful for these areas. It enables scientifically quantify multidimensional outcomes that are only known to the patient, contributes to the consideration of patient-centered treatment strategies, supports decision making, and improves the quality of healthcare [1]. Only objective esthetic and symmetry evaluation has been used to assess BR outcomes in the past; however, with the advent of well-validated BR-specific PRO measures (PROMs) [2, 3], deep understanding of various aspects of patient’s life, such as body image, pain, ease of bra wear, and psychological aspects, has become possible. Although these BR-specific measures have been incorporated into clinical studies and have deepened research on QOL after BR, the influencing factors are diverse and complex, and the evidence remains insufficient [4–6]. A scoping review of articles published in the last 5 years on this area was conducted to map and organize which world regions, which methods, and which factors were investigated. This review aimed to analyze the trend of studies, rather than study outcomes, to guide future research planning. Methods This scoping review was conducted according to the principles of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement [7]. The following question guided the mapping of this scoping review: What world regions, what research methods are being used, and what research questions are being investigated in recent clinical studies on satisfaction and QOL after mastectomy and BR? Literature search The literature search was conducted in August 2022. PubMed, MEDLINE, and CINAHL databases were searched for relevant English-language studies published from 2017 to 2022. The combination of search terms “breast reconstruction” and “breast cancer” with “patient-reported outcomes” or “satisfaction” or “quality of life” was used. Selection of eligible studies The inclusion and exclusion criteria were predetermined to select the relevant studies. The studies were included if it fulfilled all of following criteria: (1) studies involving women with breast cancer or with hereditary breast and ovarian cancer syndrome (HBOC) and underwent therapeutic or prophylactic mastectomy (PM), (2) studies involving women who underwent immediate BR (IBR) or delayed BR (DBR), (3) studies that assessed postoperative satisfaction and QOL using the BR-specific PROMs (namely, BREAST-Q [8, 9], Breast Reconstruction Satisfaction Questionnaire (BRECON-31) [10–12], and the European Organization for Research and Treatment of Cancer Quality of life Questionnaire BRR26 (EORTC QLQ-BRR26) [13, 14], which were assessed as well-developed in a previous study), and examined factors that affect them [2], and (4) any type of BR including autologous and implant-based BR, and secondary procedures such as fat grafting, nipple reconstruction, contralateral symmetrization. The exclusion criteria were as follows: (1) studies about BR following breast conserving surgery (BCS), (2) studies that compared BR with MT and BCS, and (3) opinion, review, letter, meta-analysis, case report, case series, pre-post study, qualitative study. Two reviewers (MS and RN) independently screened the title and abstracts to determine whether the studies met the criteria. Disagreements were resolved by further discussion between the two reviewers. Data collection, analysis, and reporting of results After determining studies eligible for inclusion in the final review, data were extracted by a reviewer (MS) to identify the following aspects: (a) region and country of the first author, (b) publication year, (c) study design, (d) PROM used, (e) time point of the PRO survey, and (f) research theme. Endnote and Excel were used for the management and analysis of studies. The number of publications was described by country, year, and methodology of PRO investigation. The main themes of the study were divided into the following four categories: (i) factors related to reconstructive surgery, (ii) clinical factors related to indication and treatment, (iii) patient factors, and (iv) factors affecting QOL and satisfaction. After the categorization was reconfirmed by another reviewer (RN), the distribution of study themes by region was analyzed. Results In total, 1177 studies were retrieved from the literature search, 294 full texts were reviewed, and 147 articles were included in the final analysis (Fig. 1).Fig. 1 PRISMA flow diagram of the search results Region and publication year Table 1 shows the countries of affiliation of the first author. Of the 147 studies, 69 (46.9%) were from North America, followed by 57 (38.8%) from Europe. Moreover, 17 (11.6%) papers were from Asia, of which more than half were from China. Very few papers were published from the rest of the world.Table 1 Geographical classification of the included articles Region, country No. of articles A. North America 69 (46.9%)  USA 67  Canada 2 B. Europe 57 (38.8%)  UK 14  Italy 14  Netherlands 8  Sweden 7  Spain 5  Germany 4  Belgium 2  Czech Republic 2  Norway 1 C. Asia 17 (11.6%)  China 9  Taiwan 4  Japan 2  India 1  Saudi Arabia 1 D. Oceania 3 (2.0%)  Australia 3 E. South America 1 (0.7%)  Brazil 1 As shown in the number of publications each year by region, the number consistently exceeds 10 in North America and is increasing in Europe and other regions (Fig. 2).Fig. 2 Distribution of studies by world regions from 2017 to 2022. The search was completed in August 2022 Method to investigate PROs Table 2 shows the characteristic regarding the methodology of the studies included, which were as follows: 76 (51.7%) cross-sectional studies, 23 (15.6%) retrospective cohort, 42 (28.6%) prospective studies, and 6 (4.1%) randomized controlled trials (RCT). Propensity-score matching analysis was used in three cross-sectional and two retrospective cohort studies.Table 2 Classification by methodology to investigate PROs (study characteristics) Category N (%) Study design  Cross-sectional 76 (51.7)  Retrospective cohort 23 (15.6)  Prospective cohort 42 (28.6)  RCT 6 (4.1) BR-specific PROs  BREAST-Q 142 (96.6)  EOQTC QLQ -BRR26 3 (2.0)  BRECON-31 2 (1.4) Baseline survey  Yes 51 (34.7)  No 96 (65.3) Time points of postoperative survey  Yes, multiple points 29 (19.7)  Yes, one point 36 (24.5)  Defined with a wide range 4 (2.7)  Only the lower limit is defined 24 (16.3)  Not defined 54 (36.7) PRO patient-reported outcomes, BR breast reconstruction, RCT randomized controlled trials, EOQTC QLQ -BRR26 the European organization for research and treatment of cancer quality of life questionnaire BRR26, BRECON-31 breast reconstruction satisfaction questionnaire The BREAST-Q was utilized in most of the studies. Preoperative baseline surveys were conducted in 51 (34.7%) studies. The timing of the postoperative survey was defined in 65 (44.2%) of the studies, whereas others were not clearly defined (36.7%), had only a lower limit such as “six months or more” (16.3%), or were broad to include years (2.7%). Study themes The classification of the main themes of the studies is presented in Table 3. Eighty-one (55.1%) studies were classified into BR surgery-related themes. Of which these studies, 20 (13.6%) compared autologous-tissue BR (ATBR) and implant-based BR (IBBR) [15–34]. Eight (5.4%) studies focused on ATBR-specific themes, which included three studies that compared ATBR types [35–37] and five studies that focused on abdominal-based flap techniques and various topics: laterality of pedicle [38], utilization of indocyanine green angiography [39], studies on the recipient vessels [40], nerve coaptation to the sensory nerve [41], and vascularized lymph node transfer performed simultaneously [42]. IBBR-specific themes were the most common topic of 34 (23.1%) studies, which included 10 studies that compared the direct-to-implant (DTI) procedure with staged procedure [43–52], 9 that compared subpectoral DTI with and without mesh support [53–61], 7 that compared subpectoral and pre-pectoral implant insertion [62–68], 4 that compared mesh types [69–72], 2 that compared implant types [73, 74], and 2 that were related to animation deformity [75, 76]. This reflects the transition in technique from conventional sub-pectoral, two-staged procedure to pre-pectoral, direct-to-implant procedure because of the widespread use of biological matrix and synthetic mesh. Moreover, 10 studies (6.8%) focused on mastectomy, of which six compared nipple-sparing mastectomy (NSM) with non-NSM [77–82], two analyzed NSM incision [83, 84], and two evaluated two new techniques: robotic mastectomy and IBBR [85] and endoscopic-assisted NSM and latissimus dorsi flap (LD) reconstruction [86]. In addition, 3 (2.0%) studies analyzed postoperative factors, of which 2 were about complications after BR, and one was about time since surgery. Furthermore, 6 (4.1%) studies examined surgical procedures other than primary breast reconstructive surgery, of which 3 analyzed re-reconstruction after failed IBBR [87–89], 2 evaluated fat grafting [90, 91], and 1 focused on contralateral symmetry procedure [92].Table 3 Classification by the main study theme Category Subcategory No. of articles (%) BR Surgery-related themes 81 (55.1)  Comparison between ATBR and IBBR 20 (13.6)  ATBR-specific theme 8(5.4) Comparison between the DIEP, SGAP, and LAP flap 1 Comparison within abdominal flaps 2 Bipedicle or unipedicle for unilateral BR 1 ICG angiography for the DIEP flap 1 Recipient vessels of the free abdominal flap 1 Nerve coaptation to the sensory nerve 1 Vascularized lymph node transfer with the DIEP flap 1  IBBR-specific theme 34 (23.1) Direct vs staged 10 Subpectoral DTI with or without mesh support 9 Subpectoral vs pre-pectoral IBBR 7 Types of mesh 4 Types of implants 2 Animation deformity 2  Mastectomy 10 (6.8) NSM and non-NSM 6 Incision of NSM 2 Endoscopic and robotic approach 2  Postoperative factors 3 (2.0) Complications after BR 2 Time since surgery 1  Other surgery 6 (4.1) Re-reconstruction after failed IBBR 3 Fat grafting 2  Contralateral symmetry procedure 1 Clinical themes 39 (26.5)  RT 20 (13.6) RT on ATBR and IBBR 3 RT and ATBR 7 RT and IBBR 10  Chemotherapy 1 (0.7)  IBR vs DBR 3 (2.0)  Laterality 5 (3.4)  HBOC and PM 8 (5.4) IBBR and ATBR for HBOC 1 Contralateral PM with unilateral therapeutic MT 4 With or without cancer in bilateral PM 3  Healthcare service 2 (1.4) Treating hospital 1 Sex of the plastic surgeon 1 Patient-related themes 21 (14.3)  Baseline characteristics 17 (11.6) Race 2 Age 3 Obesity 6 Overall health status 1 Socioeconomic status 1 Previous augmentation 1 Pre-existing psychiatric problems 3  Postoperative factors 4 (2.7) Psychosocial well-being 1 Financial toxicity 1 Postoperative opioid consumption 1 Disparity between patient and observer perception 1 Exploring predictors of satisfaction and QOL 6 (4.1) ATBR autologous-tissue breast reconstruction, BR breast reconstruction, DIEP deep inferior epigastric artery perforator, SGAP superior gluteal artery perforator, LAP lumbar artery perforator, ICG indocyanine green, DTI direct-to-implant, DBR delayed breast reconstruction, HBOC hereditary breast and ovarian cancer syndrome, IBBR implant-based breast reconstruction, IBR immediate breast reconstruction, PM prophylactic mastectomy, MT mastectomy, RT radiation therapy, QOL quality of life Thirty-nine (26.5%) studies were classified into the clinical theme. Of these studies, 20 (13.6%) assessed the effect of radiotherapy (RT) on ATBR [93–99], IBBR [100–109], or both [110–112]. Seven of these studies discussed the timing of BR and RT [95–99, 104, 108]. Moreover, 1 (0.7%) study examined the influence of chemotherapy [113], 3 (2.0%) compared immediate and delayed reconstruction [114–116], and 5 (3.4%) compared unilateral and bilateral reconstructions [117–121]. Eight studies with clinical themes (5.4%) focused on HBOC and PM, in which the issues to consider were complex, namely whether to perform contralateral PM in women with unilateral breast cancer [122–124] and compare them with women with bilateral breast cancer [125], comparison between BPM cases with and without previous cancer [126–128], and comparison between IBBR and ATBR for women with BRCA mutation [129]. Furthermore, 2 (1.4%) studies examined healthcare services such as the treating hospital [130] and the sex of the plastic surgeon [131]. Moreover, 21 (14.3%) studies had patient-related themes, of which 17 (11.6%) were on baseline characteristics. Obesity was the most frequently studied factor [132–137], followed by age [138–140] and pre-existing psychiatric problems [141–143]. Other baseline characteristics included race [144, 145], overall health status [146], socioeconomic status [147], and history of previous augmentation surgery [148]. Four studies (2.7%) examined the effect of postoperative patient factors such as postoperative opioid consumption [149], financial burden of BR [150], disparity between patient and observer perceptions of outcomes [151], and psychosocial well-being [152]. Six studies (4.1%) explored predictors of satisfaction and QOL after BR [153–158]. The factors extracted from these studies were nicotine dependence [155], antibody treatment [155], lymphedema [155], breast sensitivity [154], pain [154], scar thickness [154], time since surgery [153, 154], preoperative and postoperative psychosocial well-being [154, 156], preoperative sexual wellbeing [156], preoperative physical well-being of abdomen [157], reconstructive procedure [153], and race [157]. Figure 3 shows the distribution of the study themes by world regions. Studies on reconstructive techniques and treatment strategies have been conducted in all regions; however, studies on patient factors such as obesity, race, and age have been conducted mainly in North America.Fig. 3 Distribution of study themes by region. ATBR autologous-tissue breast reconstruction, BR breast reconstruction, DBR delayed breast reconstruction, HBOC hereditary breast and ovarian cancer syndrome, IBBR implant-based breast reconstruction, IBR immediate breast reconstruction, PM prophylactic mastectomy, RT radiation therapy Discussion BR-specific PROMs developed in North America and Europe have been translated and disseminated in many countries, and the BREAST-Q is now the most used worldwide, contributing to the increase in the number and diversification of studies in satisfaction and QOL after BR. As regards recent trends in research themes, in addition to the basic theme of autologous tissues in comparison with implants, optimization of the outcomes of each surgery by stratifying treatment factors and patient factors has been investigated. Studies have also discussed ATBR techniques based on abdominal flap BR to further improve the QOL of patients; however, the introduction of new surgical materials such as acellular dermal matrices (ADM) has led to changes in surgical techniques in IBBR, and many studies have evaluated new techniques from the perspective of patient satisfaction and QOL. Another major focus of the world is radiation therapy. Since BR is a part of breast cancer treatment, the timing of treatment and reconstruction is a major clinical issue. As patient factors, in addition to demographic factors such as race and age, obesity, preoperative psychiatric disorders, and postoperative psychological aspects are being considered, and these studies have been conducted mainly in North America. These patient factors should be considered potential confounders in future clinical studies. In clinical practice, patient education on these factors and patient support from the preoperative to the postoperative period were suggested to improve postoperative satisfaction and QOL. Studies using BR-specific measures were expected to accumulate and be integrated into future meta-analyses with a higher level of evidence. However, potential barriers are the quality of each study [4, 5, 159] and the heterogeneity of cultural regions [5]. Regarding the methodology of the PRO surveys analyzed in this review, only six RCTs have been conducted in five years [28, 44, 57, 58, 71, 85]. In BR, where the patient makes the decision, RCTs are difficult to conduct ethically, especially in determining surgical techniques. A strategy to compensate for the limitations of observational studies in these areas is to employ propensity-matched analysis to adjust for confounding [5], which was performed in three cross-sectional studies [24, 26, 123] and two retrospective cohort studies [30, 68]. There were 42 prospective cohort studies, of which 22 were reported in the Mastectomy Reconstruction Outcomes Consortium (MROC) study [15, 19]. MROC was conducted in 11 institutions in the United States and Canada, and PRO was evaluated longitudinally from before surgery to 2 years after surgery, and data were accumulated for various analyses including the effect of RT [93, 96, 104, 105, 111], age [138], race [144], and other factors. Such multicenter studies are a valuable reference for future clinical research. Gallo et al. stated that appropriate BREAST-Q administration, reporting of appropriate time horizon, and sample size calculations were important to ensure sufficient data quality [159]. In the present study, the time points of PRO surveys were clearly prespecified in 44.1% of the studies analyzed. Despite conflicting reports that satisfaction improves with time since surgery [115, 160] and conversely declines [23, 31, 153], the short-term and long-term results likely vary because women’s breast shape changes considerably with age, and implant-reconstructed breasts are deformed by capsular contracture. Therefore, the appropriate timing of evaluation should be determined in advance according to the purpose of the study. Cultural backgrounds, women’s body shapes, and values differ among countries, and the response patterns and average values differ even with the same scale. Thus, the extent to which the findings of other county’s studies are applicable to Japanese populations is uncertain. They are more likely to be skinny than their Western counterparts, less likely to have large ptotic breasts, and have limited donor-site volume in the abdomen and thighs. Based on body shape, Asian studies may be more helpful for Japanese than for Westerners. For example, Cheng et al. analyzed 415 patients who underwent BR with abdominal free-flap BR in Taiwan, 76.8% were of normal weight (body mass index [BMI]; 18.5 < BMI < 24.9 kg/m2) and 23.2% were overweight (25 < BMI < 29.9 kg/m2) [137], whereas Srinivasa et al. reported that 24.3% of the 634 patients who underwent ATBR and enrolled in the MROC study were classified as normal weight, 34.5% as overweight, and 41.2% as class I or higher (29.9 kg/m2 < BMI) obese [136]. Differences between countries can also be seen in healthcare resources. Specifically, biomaterials such as ADMs cannot be used under Japanese health insurance; however, many of the IBBR-related studies included in this study involved cases in which ADM was used. This suggests that while the results of studies conducted in other countries are very informative, country-specific surveys and data accumulation are needed. Studies have also reported low response rates and low average values for the sexual well-being of Japanese women based on BREAST-Q [158, 161], and Japanese may have even lower scores than other Asian women [161]. A trend was found toward generating normative data for the interpretation of BREAST-Q [162–164]. Crittenden et al. reported that the Australian normative values were significantly lower than the US normative values on four of the five subscales [162], suggesting cultural and racial differences. Future work will require the creation of normative data in Japan to better understand the effect of BR. This scoping review was conducted to map what studies on satisfaction and QOL after mastectomy and BR have been conducted, which demonstrated the increasing contribution of BR-specific PROMs worldwide and implied the need for further research in their respective culture using in appropriate methodology. This study has several limitations. It dealt only with studies that measured postoperative satisfaction or QOL after mastectomy and BR. Therefore, important topics that may have influenced QOL after reconstructive surgery such as oncoplastic surgery [165], decision aids [166], and expectation management [167, 168] were not included in the analysis. Similarly, studies that utilized other valuable PROMs to investigate perioperative pain management, decision regrets, overall health status, etc., were excluded. The authors also recognize the need to consider sample size calculations [159] and minimally important difference [169] estimation in planning future studies using PROs. In conclusion, recent BR-specific PROMs have led to a worldwide development of research on factors that affect satisfaction and QOL after BR, including a wide range of surgical, clinical, and patient factors. PROs after BR may be influenced by local cultural and social features; thus, accumulating data in each region is necessary. Acknowledgements This work was supported by JSPS KAKENHI Grant Number 22K16988 and the Okayama University Female Staff Support Grant. The authors would like to thank Enago (www.enago.jp) for the English language review. Funding Open access funding provided by Okayama University. Declarations Conflict of interest The authors declare no potential conflicts of interest. Publisher's Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. ==== Refs References 1. Winters ZE Benson JR Pusic AL A systematic review of the clinical evidence to guide treatment recommendations in breast reconstruction based on patient- reported outcome measures and health-related quality of life Ann Surg 2010 252 6 929 942 20729711 2. Davies CF Macefield R Avery K Patient-reported outcome measures for post-mastectomy breast reconstruction: a systematic review of development and measurement properties Ann Surg Oncol 2021 28 1 386 404 32602063 3. Platt J Zhong T Patient-centered breast reconstruction based on health-related quality-of-life evidence Clin Plast Surg 2018 45 1 137 143 29080656 4. Zehra S Doyle F Barry M Health-related quality of life following breast reconstruction compared to total mastectomy and breast-conserving surgery among breast cancer survivors: a systematic review and meta-analysis Breast Cancer 2020 27 4 534 566 32162181 5. Saldanha IJ, Cao W, Broyles JM et al (2021) Breast reconstruction after mastectomy: a systematic review and meta-analysis, Comparative Effectiveness Review No. 245. (Prepared by the Brown Evidence-based Practice Center under Contract No. 75Q80120D00001.) AHRQ Publication No. 21-EHC027. Rockville, MD: Agency for Healthcare Research and Quality; July 2021. 10.23970/AHRQEPCCER245 6. Khajuria A Charles WN Prokopenko M Immediate and delayed autologous abdominal microvascular flap breast reconstruction in patients receiving adjuvant, neoadjuvant or no radiotherapy: a meta-analysis of clinical and quality-of-life outcomes BJS Open 2020 4 2 182 196 32207573 7. Tricco AC Lillie E Zarin W PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation Ann Intern Med 2018 169 7 467 473 30178033 8. Cano SJ Klassen AF Scott AM The BREAST-Q: further validation in independent clinical samples Plast Reconstr Surg 2012 129 2 293 302 22286412 9. Pusic AL Klassen AF Scott AM Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q Plast Reconstr Surg 2009 124 2 345 353 19644246 10. Temple CL Cook EF Ross DC Development of a breast reconstruction satisfaction questionnaire (BRECON): dimensionality and clinical importance of breast symptoms, donor site issues, patient expectations, and relationships J Surg Oncol 2010 101 3 209 216 20082354 11. Temple-Oberle CF Cook EF Bettger-Hahn M Development of a breast reconstruction satisfaction questionnaire (BRECON-31): principal components analysis and clinimetric properties J Surg Oncol 2012 106 7 799 806 22553184 12. Temple-Oberle CF Ayeni O Cook EF The breast reconstruction satisfaction questionnaire (BRECON-31): an affirmative analysis J Surg Oncol 2013 107 5 451 455 22996073 13. Thomson HJ Winters ZE Brandberg Y The early development phases of a European Organisation for Research and Treatment of Cancer (EORTC) module to assess patient reported outcomes (PROs) in women undergoing breast reconstruction Eur J Cancer 2013 49 5 1018 1026 23063353 14. Winters ZE Balta V Thomson HJ Phase III development of the European organization for research and treatment of cancer quality of life questionnaire module for women undergoing breast reconstruction Br J Surg 2014 101 4 371 382 24474151 15. Pusic AL Matros E Fine N Patient-reported outcomes 1 year after immediate breast reconstruction: results of the mastectomy reconstruction outcomes consortium study J Clin Oncol 2017 35 22 2499 2506 28346808 16. Jeevan R Browne JP Gulliver-Clarke C Surgical determinants of patient-reported outcomes following postmastectomy reconstruction in women with breast cancer Plast Reconstr Surg 2017 139 5 1036e 1045e 28445349 17. Pirro O Mestak O Vindigni V Comparison of patient-reported outcomes after implant versus autologous tissue breast reconstruction using the BREAST-Q Plast Reconstr Surg Glob Open 2017 5 1 e1217 28203513 18. Thorarinsson A Frojd V Kolby L Long-term health-related quality of life after breast reconstruction: comparing 4 different methods of reconstruction Plast Reconstr Surg Glob Open 2017 5 6 e1316 28740762 19. Santosa KB Qi J Kim HM Long-term patient-reported outcomes in postmastectomy breast reconstruction JAMA Surg 2018 153 10 891 899 29926096 20. Fracon S Renzi N Manara M Patient satisfaction after breast reconstruction: implants vs. autologous tissues Acta Chir Plast 2018 59 3–4 120 128 29651851 21. Alshammari SM Aldossary MY Almutairi K Patient-reported outcomes after breast reconstructive surgery: a prospective cross-sectional study Ann Med Surg (Lond) 2019 39 22 25 30899456 22. Nelson JA Allen RJ Jr Polanco T Long-term patient-reported outcomes following postmastectomy breast reconstruction: an 8-year examination of 3268 patients Ann Surg 2019 270 3 473 483 31356276 23. Duraes EFR Schwarz GS de Sousa JB Factors influencing the aesthetic outcome and quality of life after breast reconstruction: a cross-sectional study Ann Plast Surg 2020 84 5 494 506 32032118 24. Kouwenberg CAE de Ligt KM Kranenburg LW Long-term health-related quality of life after four common surgical treatment options for breast cancer and the effect of complications: a retrospective patient-reported survey among 1871 patients Plast Reconstr Surg 2020 146 1 1 13 32590633 25. Ticha P Mestak O Wu M Patient-reported outcomes of three different types of breast reconstruction with correlation to the clinical data 5 years postoperatively Aesthetic Plast Surg 2020 44 6 2021 2029 32945960 26. He S Ding B Li G Comparison of outcomes between immediate implantbased and autologous reconstruction: 15-year, single-center experience in a propensity score-matched Chinese cohort Cancer Biol Med 2021 19 9 1410 1421 34846109 27. Misere RM van Kuijk SM Claassens EL Breast-related and body-related quality of life following autologous breast reconstruction is superior to implant-based breast reconstruction - a long-term follow-up study Breast 2021 59 176 182 34271290 28. Tallroth L Velander P Klasson S A short-term comparison of expander prosthesis and DIEP flap in breast reconstructions: a prospective randomized study J Plast Reconstr Aesthet Surg 2021 74 6 1193 1202 33436336 29. Cai L Momeni A The impact of reconstructive modality and postoperative complications on decision regret and patient-reported outcomes following breast reconstruction Aesthetic Plast Surg 2022 46 2 655 660 34845512 30. Nelson JA Shamsunder MG Myers PL Matched preliminary analysis of patient-reported outcomes following autologous and implant-based breast reconstruction Ann Surg Oncol 2022 29 8 5266 5275 35366702 31. Shiraishi M Sowa Y Tsuge I Long-term patient satisfaction and quality of life following breast reconstruction using the BREAST-Q: a prospective cohort study Front Oncol 2022 12 815498 35692774 32. Persichetti P Barone M, R M Salzillo R Impact on patient's appearance perception of autologous and implant based breast reconstruction following mastectomy using BREAST-Q Aesthetic Plast Surg 2022 46 3 1153 1163 35229192 33. Wolska J Ammari T Turnbull A Comparison of long-term outcomes of breast conservation and reconstruction after mastectomy using BREAST-Q J Plast Reconstr Aesthet Surg 2022 75 9 2930 2940 35780003 34. Gao P Bai P Kong X Patient-reported outcomes and complications following breast reconstruction: a comparison between biological matrix-assisted direct-to-implant and Latissimus Dorsi Flap Front Oncol 2022 12 766076 35155227 35. Erdmann-Sager J Wilkins EG Pusic AL Complications and patient-reported outcomes after abdominally based breast reconstruction: results of the mastectomy reconstruction outcomes consortium study Plast Reconstr Surg 2018 141 2 271 281 29019862 36. Atisha DM Tessiatore KM Rushing CN A national snapshot of patient-reported outcomes comparing types of abdominal flaps for breast reconstruction Plast Reconstr Surg 2019 143 3 667 677 30589826 37. Opsomer D Vyncke T Ryx M Comparing the lumbar and SGAP flaps to the DIEP flap using the BREAST-Q Plast Reconstr Surg 2020 146 3 276e 282e 32842100 38. Sergesketter AR Shammas RL Taskindoust M A Comparison of patient-reported outcomes in bipedicled total abdominal versus unipedicled hemiabdominal free flaps for unilateral breast reconstruction J Reconstr Microsurg 2021 37 9 753 763 33853131 39. Malagon-Lopez P Vila J Carrasco-Lopez C Intraoperative indocyanine green angiography for fat necrosis reduction in the deep inferior epigastric perforator (DIEP) flap Aesthet Surg J 2019 39 4 NP45 NP54 30358820 40. Ho OA Lin YL Pappalardo M Nipple-sparing mastectomy and breast reconstruction with a deep inferior epigastric perforator flap using thoracodorsal recipient vessels and a low lateral incision J Surg Oncol 2018 118 4 621 629 30212598 41. Cornelissen AJM Beugels J van Kuijk SMJ Sensation of the autologous reconstructed breast improves quality of life: a pilot study Breast Cancer Res Treat 2018 167 3 687 695 29071492 42. Di Taranto G, Coleman GJ, Hardwicke J et al (2022) A comparative study between deep inferior epigastric artery perforator flap breast reconstruction and DIEP flap breast reconstruction coupled with vascularized lymph node transfer: improving the quality of life of patients with breast cancer related lymphedema without affecting donor site outcomes. Microsurgery 43:213–221 43. Srinivasa DR Garvey PB Qi J Direct-to-implant versus two-stage tissue expander/implant reconstruction: 2-year risks and patient-reported outcomes from a prospective multicenter study Plast Reconstr Surg 2017 140 5 869 877 29068918 44. Negenborn VL Young-Afat DA Dikmans REG Quality of life and patient satisfaction after one-stage implant-based breast reconstruction with an acellular dermal matrix versus two-stage breast reconstruction (BRIOS): primary outcome of a randomised, controlled trial Lancet Oncol 2018 19 9 1205 1214 30104147 45. Cattelani L Polotto S Arcuri MF One-step prepectoral breast reconstruction with dermal matrix-covered implant compared to submuscular implantation: functional and cost evaluation Clin Breast Cancer 2018 18 4 e703 e711 29275104 46. Ghilli M Mariniello MD Camilleri V PROMs in post-mastectomy care: patient self-reports (BREAST-Q) as a powerful instrument to personalize medical services Eur J Surg Oncol 2020 46 6 1034 1040 31812290 47. Caputo GG Vigato E Rampino Cordaro E Comparative study of patient outcomes between direct to implant and two-stage implant-based breast reconstruction after mastectomy J Plast Reconstr Aesthet Surg 2021 74 10 2573 2579 33947651 48. Gao P Bai P Ren Y Biological matrix-assisted one-stage implant-based breast reconstruction versus two-stage implant-based breast reconstruction: patient-reported outcomes and complications Aesthetic Plast Surg 2021 45 6 2581 2590 34350500 49. Innocenti A Melita D Affortunati M Immediate-implant-based-breast-reconstruction with two-stage expander-implant reconstruction versus one-stage-reconstruction with acellular dermal matrix: analysis of patients' satisfaction Acta Biomed 2021 92 3 e2021228 34212931 50. Sgarzani R Pasquali S Buggi F Sub-muscular reconstruction after NAC sparing mastectomy: direct to implant breast reconstruction with human ADM versus tissue expander Aesthetic Plast Surg 2021 45 2 413 420 33078212 51. Dimovska EOF Chen C Chou HH Outcomes and quality of life in immediate one-stage versus two-stage breast reconstructions without an acellular dermal matrix: 17- years of experience J Surg Oncol 2021 124 4 510 520 34133023 52. Riggio E Alfieri S Toffoli E A descriptive comparison of satisfaction and well-being between expander-based and direct-to-implant breast reconstruction after Nipple-sparing Mastectomy Aesthetic Plast Surg 2022 10.1007/s00266-022-03061-9 36344829 53. Sorkin M Qi J Kim HM Acellular dermal matrix in immediate expander/implant breast reconstruction: a multicenter assessment of risks and benefits Plast Reconstr Surg 2017 140 6 1091 1100 28806288 54. Ganesh Kumar N Berlin NL Kim HM Development of an evidence-based approach to the use of acellular dermal matrix in immediate expander-implant-based breast reconstruction J Plast Reconstr Aesthet Surg 2021 74 1 30 40 33172826 55. Chen G Zhang Y Xue J Surgical outcomes of implant-based breast reconstruction using TiLoop Bra mesh combined with pectoralis major disconnection Ann Plast Surg 2019 83 4 396 400 31524731 56. Gao P Wang Z Kong X Comparisons of therapeutic and aesthetic effects of one-stage implant-based breast reconstruction with and without biological matrix Cancer Manag Res 2020 12 13381 13392 33402848 57. Lohmander F Lagergren J Johansson H Quality of life and patient satisfaction after implant-based breast reconstruction with or without acellular dermal matrix: randomized clinical trial BJS Open 2020 4 5 811 820 32762012 58. Lohmander F Lagergren J Johansson H Effect of immediate implant-based breast reconstruction after mastectomy with and without acellular dermal matrix among women with breast cancer: a randomized clinical trial JAMA Netw Open 2021 4 10 e2127806 34596671 59. Sewart E Turner NL Conroy EJ Patient-reported outcomes of immediate implant-based breast reconstruction with and without biological or synthetic mesh BJS Open 2021 5 1 zraa063 33609398 60. Wang S He S Zhang X Acellular bovine pericardium matrix in immediate breast reconstruction compared with conventional implant-based breast reconstruction JPRAS Open 2021 29 1 9 33937472 61. Wilson RL Kirwan CC O’Donoghue JM BROWSE: A multicentre comparison of nine year outcomes in acellular dermal matrix based and complete submuscular implant-based immediate breast reconstruction-aesthetics, capsular contracture and patient reported outcomes Eur J Surg Oncol 2022 48 1 73 81 34836730 62. Baker BG Irri R MacCallum V A prospective comparison of short-term outcomes of subpectoral and prepectoral strattice-based immediate breast reconstruction Plast Reconstr Surg 2018 141 5 1077 1084 29697602 63. Thangarajah F Treeter T Krug B Comparison of subpectoral versus prepectoral immediate implant reconstruction after skin- and nipple-sparing mastectomy in breast cancer patients: a retrospective hospital-based cohort study Breast Care (Basel) 2019 14 6 382 387 31933584 64. Manrique OJ Kapoor T Banuelos J Single-stage direct-to-implant breast reconstruction: a comparison between subpectoral versus prepectoral implant placement Ann Plast Surg 2020 84 4 361 365 31633546 65. Caputo GG Zingaretti N Kiprianidis I Quality of life and early functional evaluation in direct-to-implant breast reconstruction after mastectomy: a comparative study between prepectoral versus dual-plane reconstruction Clin Breast Cancer 2021 21 4 344 351 33308993 66. Le NK Persing S Dinis J A comparison of BREAST-Q scores between prepectoral and subpectoral direct-to-implant breast reconstruction Plast Reconstr Surg 2021 148 5 708e 714e 34705769 67. Ng EI Quah GS Graham S Immediate prepectoral implant reconstruction using TiLOOP Bra Pocket results in improved patient satisfaction over dual plane reconstruction ANZ J Surg 2021 91 4 701 707 33634944 68. Nelson JA Shamsunder MG Vorstenbosch J Prepectoral and subpectoral tissue expander-based breast reconstruction: a propensity-matched analysis of 90-day clinical and health-related quality-of-life outcomes Plast Reconstr Surg 2022 149 4 607e 616e 35103644 69. Hallberg H Elander A Kolby L A biological or a synthetic mesh in immediate breast reconstruction? A cohort-study of long-term health related quality of life (HrQoL) Eur J Surg Oncol 2019 45 10 1812 1816 30905394 70. Ohlinger R Alwafai Z Paepke S Patient quality of life after subpectoral implant-based breast reconstruction with synthetic or biological materials Anticancer Res 2021 41 6 3075 3082 34083300 71. Stein MJ Arnaout A Lichtenstein JB A comparison of patient-reported outcomes between Alloderm and Dermacell in immediate alloplastic breast reconstruction: a randomized control trial J Plast Reconstr Aesthet Surg 2021 74 1 41 47 32893151 72. Gao P Wang X Bai P Clinical outcomes and patient satisfaction with the use of biological and synthetic meshes in one-stage implant-based breast reconstruction Breast Cancer 2022 29 3 450 457 34978672 73. Khavanin N Clemens MW Pusic AL Shaped versus round implants in breast reconstruction: a multi-institutional comparison of surgical and patient-reported outcomes Plast Reconstr Surg 2017 139 5 1063 1070 28445350 74. Vorstenbosch J McCarthy CM Shamsunder MG Smooth versus textured implant breast reconstruction: patient-reported outcomes and complications Plast Reconstr Surg 2021 148 5 959 967 34705770 75. Bernini M Sordi S Bembi N Selective denervation of pectoralis major muscle improves cosmetic outcome and quality of life in retro-pectoral implant based breast reconstruction Clin Breast Cancer 2022 22 1 60 66 34393050 76. Fracol M Qiu CS Chiu MW The relationship between animation deformity and patient-reported outcomes: application of the BREAST-Q to a quantitative stratification of animation severity Plast Reconstr Surg 2020 145 1 11 17 31577656 77. Bailey CR Ogbuagu O Baltodano PA Quality-of-life outcomes improve with nipple-sparing mastectomy and breast reconstruction Plast Reconstr Surg 2017 140 2 219 226 28746266 78. Romanoff A Zabor EC Stempel M A comparison of patient-reported outcomes after nipple-sparing mastectomy and conventional mastectomy with reconstruction Ann Surg Oncol 2018 25 10 2909 2916 29968023 79. Yoon-Flannery K DeStefano LM De La Cruz LM Quality of life and sexual well-being after nipple sparing mastectomy: a matched comparison of patients using the breast Q J Surg Oncol 2018 118 1 238 242 30114323 80. Opsomer D Vyncke T Depypere B Nipple reconstruction in autologous breast reconstruction after areola-sparing mastectomy J Plast Reconstr Aesthet Surg 2021 74 6 1223 1228 33279428 81. Santosa KB Qi J Kim HM Comparing Nipple-sparing mastectomy to secondary nipple reconstruction: a multi-institutional study Ann Surg 2021 274 2 390 395 31469747 82. Racz JM Harless CA Hoskin TL Sexual well-being after nipple-sparing mastectomy: does preservation of the nipple matter? Ann Surg Oncol 2022 29 4167 4179 83. Corso G De Lorenzi F Vicini E Nipple-sparing mastectomy with different approaches: surgical incisions, complications, and cosmetic results preliminary results of 100 consecutive patients at a single center J Plast Reconstr Aesthet Surg 2018 71 12 1751 1760 30197065 84. Odom EB Parikh RP Um G Nipple-sparing mastectomy incisions for cancer extirpation prospective cohort trial: perfusion, complications, and patient outcomes Plast Reconstr Surg 2018 142 1 13 26 29878989 85. Toesca A Sangalli C Maisonneuve P A randomized trial of robotic mastectomy versus open surgery in women with breast cancer or BrCA mutation Ann Surg 2022 276 1 11 19 34597010 86. Qiu J Wen N Xie Y Novel technique for endoscopic-assisted nipple-sparing mastectomy and immediate breast reconstruction with endoscopic-assisted latissimus dorsi muscle flap harvest through a single axillary incision: a retrospective cohort study of comparing endoscopic and open surgery Gland Surg 2022 11 8 1383 1394 36082086 87. Haque S Kanapathy M Bollen E Patient-reported outcome and cost implication of acute salvage of infected implant-based breast reconstruction with negative pressure wound therapy with Instillation (NPWTi) compared to standard care J Plast Reconstr Aesthet Surg 2021 74 12 3300 3306 34217644 88. Asaad M Slovacek C Mitchell D Surgical and patient-reported outcomes of autologous versus implant-based reconstruction following infected breast device explantation Plast Reconstr Surg 2022 149 6 1080e 1089e 35349553 89. Shammas RL Sergesketter AR Taskindoust M Assessing the influence of failed implant reconstruction on patient satisfaction and decision regret after salvage free-flap breast reconstruction J Reconstr Microsurg 2022 38 6 441 450 34425595 90. Bennett KG Qi J Kim HM Association of fat grafting with patient-reported outcomes in postmastectomy breast reconstruction JAMA Surg 2017 152 10 944 950 28658472 91. Qureshi AA Odom EB, RP EB Parikh RP Patient-reported outcomes of aesthetics and satisfaction in immediate breast reconstruction after nipple-sparing mastectomy with implants and fat grafting Aesthet Surg J 2017 37 9 999 1008 28379284 92. Razdan SN Panchal H Albornoz CR Impact of contralateral symmetry procedures on long-term patient-reported outcomes following unilateral prosthetic breast reconstruction J Reconstr Microsurg 2019 35 2 124 128 30099735 93. Cooke AL Diaz-Abele J Hayakawa T Radiation therapy versus no radiation therapy to the neo-breast following skin-sparing mastectomy and immediate autologous free flap reconstruction for breast cancer: patient-reported and surgical outcomes at 1 year-a mastectomy reconstruction outcomes consortium (MROC) substudy Int J Radiat Oncol Biol Phys 2017 99 1 165 172 28816143 94. Pont LP Marcelli S Robustillo M Immediate breast reconstruction with abdominal free flap and adjuvant radiotherapy: evaluation of quality of life and outcomes Plast Reconstr Surg 2017 140 4 681 690 28609351 95. He S Yin J Robb GL Considering the optimal timing of breast reconstruction with abdominal flaps with adjuvant irradiation in 370 consecutive pedicled transverse rectus abdominis myocutaneous flap and free deep inferior epigastric perforator flap performed in a chinese oncology center: is there a significant difference between immediate and delayed? Ann Plast Surg 2017 78 6 633 640 27798424 96. Billig J Jagsi R Qi J Should Immediate autologous breast reconstruction be considered in women who require postmastectomy radiation therapy? A prospective analysis of outcomes Plast Reconstr Surg 2017 139 6 1279 1288 28198770 97. Steele KH Macmillan RD Ball GR Multicentre study of patient-reported and clinical outcomes following immediate and delayed autologous breast reconstruction and radiotherapy (ABRAR study) J Plast Reconstr Aesthet Surg 2018 71 2 185 193 29203259 98. O'Connell RL Di Micco R Khabra K Comparison of immediate versus delayed diep flap reconstruction in women who require postmastectomy radiotherapy Plast Reconstr Surg 2018 142 3 594 605 29927832 99. Kamel GN Nash D Jacobson J Patient-reported satisfaction and quality of life in postmastectomy radiated patients: a comparison between delayed and delayed immediate autologous breast reconstruction in a predominantly minority patient population J Reconstr Microsurg 2019 35 6 445 451 30716775 100. Hamann M Brunnbauer M Scheithauer H Quality of life in breast cancer patients and surgical results of immediate tissue expander/implant-based breast reconstruction after mastectomy Arch Gynecol Obstet 2019 300 2 409 420 31144025 101. Tejera Hernandez AA Vega Benitez VM Rocca Cardenas JC Inverse radiotherapy planning in reconstructive surgery for breast cancer Int J Surg 2019 63 77 82 30708063 102. Thiboutot E Craighead P Webb C Patient-reported satisfaction following radiation of implant-based breast reconstruction Plast Surg (Oakv) 2019 27 2 147 155 31106173 103. Koppiker CB Ul Noor A Dixit S Implant-based breast reconstruction with autologous lower dermal sling and radiation therapy outcomes Indian Journal of Surgery 2019 81 6 543 551 104. Yoon AP Qi J Kim HM Patient-reported outcomes after irradiation of tissue expander versus permanent implant in breast reconstruction: a multicenter prospective study Plast Reconstr Surg 2020 145 5 917e 926e 32332528 105. Olinger TA Berlin NL Qi J Outcomes of immediate implant-based mastectomy reconstruction in women with previous breast radiotherapy Plast Reconstr Surg 2020 145 6 1029e 1036e 32195865 106. Seth AK Cordeiro PG Stability of long-term outcomes in implant-based breast reconstruction: an evaluation of 12-year surgeon- and patient-reported outcomes in 3489 nonirradiated and irradiated implants Plast Reconstr Surg 2020 146 3 474 484 32842095 107. Coude Adam H Frisell A Liu Y Effect of radiotherapy on expanders and permanent implants in immediate breast reconstruction: long-term surgical and patient-reported outcomes in a large multicentre cohort Br J Surg 2021 108 12 1474 1482 34694356 108. Nelson JA Cordeiro PG Polanco T Association of radiation timing with long-term satisfaction and health-related quality of life in prosthetic breast reconstruction Plast Reconstr Surg 2022 150 1 32e 41e 35499580 109. Sewart E Turner NL Conroy EJ The impact of radiotherapy on patient-reported outcomes of immediate implant-based breast reconstruction with and without mesh Ann Surg 2022 275 5 992 1001 32657919 110. Devulapalli C Bello RJ Moin E The effect of radiation on quality of life throughout the breast reconstruction process: a prospective, longitudinal pilot study of 200 patients with long-term follow-up Plast Reconstr Surg 2018 141 3 579 589 29481390 111. Jagsi R Momoh AO Qi J Impact of radiotherapy on complications and patient-reported outcomes after breast reconstruction J Natl Cancer Inst 2018 110 2 157 165 28954300 112. Reinders FCJ Young-Afat DA Batenburg MCT Higher reconstruction failure and less patient-reported satisfaction after post mastectomy radiotherapy with immediate implant-based breast reconstruction compared to immediate autologous breast reconstruction Breast Cancer 2020 27 3 435 444 31858435 113. Hart SE Brown DL Kim HM Association of clinical complications of chemotherapy and patient-reported outcomes after immediate breast reconstruction JAMA Surg 2021 156 9 847 855 34160601 114. Yoon AP Qi J J Brown DL Outcomes of immediate versus delayed breast reconstruction: results of a multicenter prospective study Breast 2018 37 72 79 29102781 115. Dempsey K Mathieu E Brennan M The role of breast reconstruction choice on body image patient-reported outcomes at four years post-mastectomy for breast cancer: a longitudinal prospective cohort study Psychooncology 2022 31 1 54 61 34498358 116. Ochoa O Garza R, 3rd Pisano S Prospective longitudinal patient-reported satisfaction and health-related quality of life following DIEP flap breast reconstruction: effects of reconstruction timing Plast Reconstr Surg 2022 149 5 848e 857e 35245253 117. Kuykendall LV Tugertimur B Agoris C Unilateral versus bilateral breast reconstruction: is less really more? Ann Plast Surg 2017 78 6S Suppl 5 S275 S278 28328628 118. Taylor EM Wilkins EG Pusic AL Impact of unilateral versus bilateral breast reconstruction on procedure choices and outcomes Plast Reconstr Surg 2019 143 6 1159e 1168e 31136472 119. Allen RJ Jr Sobti N Patel AR Laterality and patient-reported outcomes following autologous breast reconstruction with free abdominal tissue: an 8-year examination of BREAST-Q data Plast Reconstr Surg 2020 146 5 964 975 33141527 120. McFadden EM Lopez-Obregon B Stone JP Direct-to-implant breast reconstruction with autoderm Plast Reconstr Surg Glob Open 2018 6 12 e2027 30656114 121. Cogliandro A Salzillo R Barone M Direct-to-implant breast reconstruction after unilateral and bilateral mastectomy: cross-sectional study of patient satisfaction and quality of life with BREAST-Q Aesthetic Plast Surg 2022 47 43 49 35927501 122. Momoh AO Cohen WA Kidwell KM Tradeoffs associated with contralateral prophylactic mastectomy in women choosing breast reconstruction: results of a prospective multicenter cohort Ann Surg 2017 266 1 158 164 27355266 123. Asaad M Boukovalas S Chu CK Financial toxicity and contralateral prophylactic mastectomy: an analysis using propensity score methods Breast Cancer Res Treat 2020 183 3 649 659 32691378 124. Kerrebijn I Retrouvey H Harma M Contralateral prophylactic mastectomy at the time of delayed microvascular breast reconstruction adversely affects patient-reported outcomes: a retrospective cohort study J Plast Reconstr Aesthet Surg 2021 74 4 785 791 33214123 125. Kazzazi F Haggie R Forouhi P A comparison of patient satisfaction (using the BREAST-Q questionnaire) with bilateral breast reconstruction following risk-reducing or therapeutic mastectomy J Plast Reconstr Aesthet Surg 2018 71 9 1324 1331 30025758 126. Bai L Arver B Johansson H Body image problems in women with and without breast cancer 6–20 years after bilateral risk-reducing surgery - a prospective follow-up study Breast 2019 44 120 127 30743225 127. Gandhi A Duxbury P Murphy J Patient reported outcome measures in a cohort of patients at high risk of breast cancer treated by bilateral risk reducing mastectomy and breast reconstruction J Plast Reconstr Aesthet Surg 2022 75 1 69 76 34219040 128. Herold N Hellmich M M Lichtenheldt F Satisfaction and quality of life of healthy and unilateral diseased BRCA1/2 pathogenic variant carriers after risk-reducing mastectomy and reconstruction using the BREAST-Q questionnaire Genes (Basel) 2022 13 8 1357 36011268 129. Moberg IO Schou Bredal I Schneider MR Complications, risk factors, and patients-reported outcomes after skin-sparing mastectomy followed by breast reconstruction in women with BRCA mutations J Plast Surg Hand Surg 2018 52 4 234 239 29741462 130. Berlin NL Tandon VJ Qi J Hospital variations in clinical complications and patient-reported outcomes at 2 years after immediate breast reconstruction Ann Surg 2019 269 5 959 965 29489482 131. Hsu JJ Kubiak CA Billig JI Perceived versus patient-reported significance of surgeon gender in breast reconstruction Plast Reconstr Surg 2021 148 4 720 728 34550924 132. Kamel GN Mehta K Nash D Patient-reported satisfaction and quality of life in obese patients: a comparison between microsurgical and prosthetic implant recipients Plast Reconstr Surg 2019 144 6 960e 966e 31764628 133. Klement KA Hijjawi JB LoGiudice LA Microsurgical breast reconstruction in the obese: a better option than tissue expander/implant reconstruction? Plast Reconstr Surg 2019 144 3 539 546 31460996 134. Ochoa O Garza R, 3rd Pisano S Prospective longitudinal patient-reported satisfaction and health-related quality of life following DIEP flap breast reconstruction: relationship with body mass index Plast Reconstr Surg 2019 143 6 1589 1600 30907803 135. Nelson JA Sobti N Patel A The impact of obesity on patient-reported outcomes following autologous breast reconstruction Ann Surg Oncol 2020 27 6 1877 1888 31811437 136. Srinivasa DR Clemens MW Qi J obesity and breast reconstruction: complications and patient-reported outcomes in a multicenter prospective study Plast Reconstr Surg 2020 145 3 481e 490e 32097295 137. Cheng MH Koide S Chen C Comparisons between normal body mass index and overweight patients who underwent unilateral microsurgical breast reconstructions Ann Surg Oncol 2021 28 1 353 362 32901309 138. Kuykendall LV Zhang A Tugertimur B Outcomes in deep inferior epigastric perforator flap and implant-based reconstruction: does age really matter? Cancer Control 2018 25 1 1073274817744603 29325422 139. Oh DD Flitcroft K Brennan ME Patient-reported outcomes of breast reconstruction in older women: audit of a large metropolitan public/private practice in Sydney, Australia Psychooncology 2018 27 12 2815 2822 30225915 140. Dominici L Hu J Zheng Y Association of local therapy with quality-of-life outcomes in young women with breast cancer JAMA Surg 2021 156 10 e213758 34468718 141. Klifto KM Bekheet FN Manahan MA The effects of depression and anti-depressants on quality of life after breast reconstruction: a post-hoc analysis Cureus 2021 13 10 e18675 34786255 142. Mehta SK Sheth AH Olawoyin O Patients with psychiatric illness report worse patient-reported outcomes and receive lower rates of autologous breast reconstruction Breast J 2020 26 10 1931 1936 32529691 143. Shamsunder MG Chu JJ Polanco TO The impact of psychiatric diagnoses on patient-reported satisfaction and quality of life in post-mastectomy breast reconstruction Ann Surg 2022 10.1097/SLA.0000000000005478 35793069 144. Berlin NL Momoh AO Qi J Racial and ethnic variations in one-year clinical and patient-reported outcomes following breast reconstruction Am J Surg 2017 214 2 312 317 28215963 145. Oskar S Nelson JA Hicks MEV The impact of race on perioperative and patient-reported outcomes following autologous breast reconstruction Plast Reconstr Surg 2022 149 1 15 27 34936598 146. Mehta SK Olawoyin O Chouairi F Worse overall health status negatively impacts satisfaction with breast reconstruction J Plast Reconstr Aesthet Surg 2020 73 11 2056 2062 32972879 147. Le NK Gabrick KS Chouairi F Impact of socioeconomic status on psychological functioning in survivorship following breast cancer and reconstruction Breast J 2020 26 9 1695 1701 32337778 148. Baker BG Sewart E Harvey J Implant-based reconstruction following mastectomy in patients who have had a previous breast augmentation: lessons from the national multicenter implant breast reconstruction evaluation study Plast Reconstr Surg 2022 149 2 324 337 35077406 149. Nelson JA Polanco TO Shamsunder MG Perioperative inpatient opioid consumption following autologous free-flap breast reconstruction patients: an examination of risk and patient-reported outcomes Ann Surg Oncol 2021 28 12 7823 7833 33959829 150. Coroneos CJ Lin YL Sidey-Gibbons C Correlation between financial toxicity, quality of life, and patient satisfaction in an insured population of breast cancer surgical patients: a single-institution retrospective study J Am Coll Surg 2021 232 3 253 263 33316424 151. Wu SS Duraes EFR Scomacao I Beauty is in the eye of the beholder: factors influencing disparity in perceptions of breast reconstruction aesthetic outcomes Plast Reconstr Surg 2022 150 1 42e 50e 35499515 152. Gil-Olarte P, Gil-Olarte MA, Gomez-Molinero R et al (2022) Psychosocial and sexual well-being in breast cancer survivors undergoing immediate breast reconstruction: The mediating role of breast satisfaction. Eur J Cancer Care (Engl) 31:e13686 153. Santanelli Di Pompeo F Barone M Salzillo R Predictive factors of satisfaction following breast reconstruction: do they influence patients? Aesthetic Plast Surg 2022 46 2 610 618 34559281 154. Matthews H Carroll N Renshaw D Predictors of satisfaction and quality of life following post-mastectomy breast reconstruction Psychooncology 2017 26 11 1860 1865 28195672 155. Cereijo-Garea C Pita-Fernandez S Acea-Nebril B Predictive factors of satisfaction and quality of life after immediate breast reconstruction using the BREAST-Q((c)) J Clin Nurs 2018 27 7–8 1464 1474 29396899 156. van de Grift TC Mureau MAM Negenborn VN Predictors of women's sexual outcomes after implant-based breast reconstruction Psychooncology 2020 29 8 1272 1279 32419285 157. Stone JP Bello RJ Siotos C Patient-related risk factors for worsened abdominal well-being after autologous breast reconstruction Plast Reconstr Surg 2020 145 3 475e 480e 32097290 158. Shiraishi M Sowa Y Inafuku N Long-term survey of sexual well-being after breast reconstruction using the BREAST-Q in the Japanese population Asian J Surg 2022 46 150 155 35221188 159. Gallo L Chu JJ Shamsunder MG Best practices for BREAST-Q research: a systematic review of study methodology Plast Reconstr Surg 2022 150 3 526e 535e 35749737 160. Fontein DBY Oros M Held L Patient-reported outcomes in free-flap breast reconstructive surgery over time (PRO-BREST) Breast Care (Basel) 2022 17 3 272 278 35949418 161. Saiga M Taira N Kimata Y Development of a Japanese version of the BREAST-Q and the traditional psychometric test of the mastectomy module for the assessment of HRQOL and patient satisfaction following breast surgery Breast Cancer 2017 24 2 288 298 27179527 162. Crittenden TA Smallman A Dean NR Normative data for the BREAST-Q Reconstruction module in an Australian population and comparison with US norms and breast reconstruction patient outcomes J Plast Reconstr Aesthet Surg 2022 75 7 2219 2228 35184998 163. Klifto KM Aravind P Major M Differences between breast cancer reconstruction and institutionally established normative data using the BREAST-Q reconstruction module: a comparative study Plast Reconstr Surg 2020 145 6 1371 1379 32459767 164. Mundy LR Homa K Klassen AF Breast cancer and reconstruction: normative data for interpreting the BREAST-Q Plast Reconstr Surg 2017 139 5 1046e 1055e 28445351 165. Li Y Guo J Sui Y Quality of life in patients with breast cancer following breast conservation surgery: a systematic review and meta-analysis J Healthc Eng 2022 2022 3877984 35140901 166. Berlin NL Tandon VJ Hawley ST Feasibility and efficacy of decision aids to improve decision making for postmastectomy breast reconstruction: a systematic review and meta-analysis Med Decis Making 2019 39 1 5 20 30799692 167. Pusic AL Klassen AF Snell L Measuring and managing patient expectations for breast reconstruction: impact on quality of life and patient satisfaction Expert Rev Pharmacoecon Outcomes Res 2012 12 2 149 158 22458616 168. Shamsunder MG Polanco TO McCarthy CM Understanding preoperative breast satisfaction among patients undergoing mastectomy and immediate reconstruction: BREAST-Q insights Plast Reconstr Surg 2021 148 6 891e 902e 34847108 169. Voineskos SH Klassen AF Cano SJ Giving meaning to differences in BREAST-Q scores: minimal important difference for breast reconstruction patients Plast Reconstr Surg 2020 145 1 11e 20e 31577656