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1 The postmastectomy breast reconstruction with deep inferior epigastric perforator (DIEP) flap is the first choice in autologous reconstruction for the low risk of complications and the aesthetically pleasing outcome.1,2 The increased survival rate of patients with breast cancer led the medical community to focus on the patient-reported outcome measures.3 The BREAST-Q is an universally accepted tool for evaluation of quality of life and satisfaction in breast surgery.4 The aim of our study was to identify differences in patient-reported outcomes in immediate and delayed reconstruction with DIEP flap. The BREAST-Q reconstruction module was sent to 20 immediate and 20 delayed DIEP flap reconstruction patients. We collected data preoperatively and postoperatively at 1, 6, and 12 months. The BREAST-Q Scoring software was used to generate the Q-scores. The statistical analysis of Q-scores was performed using IBM SPSS Statistics 20 (SPSS, Inc., Chicago, Ill), and differences was assessed using the Mann-Whitney U test with a statistical significance level of P < 0.05. At preoperative time, the delayed reconstruction group had significantly lower Q-scores in quality of life domains. There were no significant differences between the immediate and delayed group in quality of life domains at 12 months. The Q-score trend of satisfaction with breast in immediate group showed a deflection at 1 postoperative month followed by improvement and return to baseline at 6 months. Also in delayed group the Q-score trend of satisfaction with breast showed a deflection at 1 postoperative month followed by progressive improvement. A higher increase of Q-score value in satisfaction with breast subscale at 12 months was recorded in patients undergoing delayed DIEP flap reconstruction (P, 0.031; Fig. 1). In both groups, the Q-scores in satisfaction with abdomen subscales showed a considerable postoperative increase. The satisfaction of patients undergoing delayed DIEP flap reconstruction was greater, probably due to the higher expectations on reconstructive outcomes based on preoperative conditions. The restoration of baseline values at 6 months in patients undergoing immediate reconstruction suggests that these patients are satisfied with breast reconstruction as well as breast before surgery.

Patient-reported Outcomes in Immediate and Delayed Breast Reconstruction with Deep Inferior Epigastric Perforator Flap