Abstract
Background: Breast cancer continues to be a leading cause of morbidity among women worldwide, and mastectomy is a common treatment option. Breast reconstruction provides women the opportunity to restore their physical appearance and improve quality of life. This literature review explores the effects of immediate versus delayed breast reconstruction on patient-reported outcomes (PROs), including psychological well-being, body image satisfaction, and overall quality of life.
Methods: A comprehensive search of peer-reviewed articles published within the last two decades was conducted in databases including Cochrane Library, Scopus, and PubMed, Scopus. Studies were included if they compared immediate and delayed breast reconstruction, focusing on PROs. Data was extracted on psychological outcomes, aesthetic satisfaction, complications, and treatment timelines.
Results: The review identified 23 relevant studies, which indicated that immediate breast reconstruction is associated with improved short-term psychological outcomes and higher body image satisfaction. However, the complication rates were higher in immediate reconstruction when postoperative radiotherapy was required. Delayed reconstruction provided patients with more time to psychologically adjust and make informed decisions about their surgical options, though this approach was often linked to prolonged feelings of loss and body dissatisfaction post-mastectomy.
Conclusion: Immediate breast reconstruction offers distinct psychological and aesthetic benefits, particularly in enhancing body image satisfaction. The risk of complications and the potential need for subsequent surgeries raises important considerations. Delayed reconstruction can facilitate better decision-making but may prolong emotional challenges. Ultimately, the choice between immediate and delayed reconstruction should be individualised, taking into account the patient's medical condition, treatment plan, and personal preferences to optimise patient-reported outcomes.
Keywords: Breast Reconstruction, Immediate Reconstruction, Delayed Reconstruction, Patient-Reported Outcomes, Quality of Life, Body Image, Mastectomy.