Patient satisfaction after breast reconstruction in a high-risk breast cancer population

Background: Women with an elevated risk for breast cancer due to a BRCA1 or BRCA2 pathogenic variant can choose for surveillance or risk reducing mastectomy (RRM). Breast reconstruction improves quality of life (QoL). However, in this high-risk population, the effect of breast reconstruction on QoL nor the level of satisfaction afterward is widely researched. This cross-sectional study aimed to determine the long-term satisfaction level with breast reconstruction in a high-risk breast cancer population. Method: Women who underwent breast reconstruction were invited to complete several online questionnaires including the BREAST-Q, SF-36, general questions on their health and DNA test results, and the course of diagnosis and treatment. In the analyses two groups were compared: patients with breast reconstruction after risk-reducing mastectomy (BRaRRM) and patients with breast reconstruction after breast cancer (BRaBC). Results: About 935 participants completed all questionnaires of whom 535 underwent breast reconstruction and were included in this analysis. There was no difference between BREAST-Q "satisfaction with outcome" scales between the BRaRRM and BRaBC groups (60.9 vs 60.9). According to our multivariable linear regression analysis, higher age had a positive association with satisfaction with outcome, and both secondary and implant-based reconstruction were negatively associated with satisfaction with outcome ( b = 0.21, b = -2.10, b = -5.83). Conclusion: RRM combined with breast reconstruction is a good option for women with high risk of breast cancer. No difference in the BREAST-Q satisfaction with outcome scale was observed between both groups. Age, type, and timing of reconstruction should be considered when deciding on RRM. (c) 2025 The Author(s). Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)