Breast-Conserving Surgery Associated With Higher Satisfaction Than Mastectomy With Implant Reconstruction

A study in the World Journal of Surgery compared postoperative patient-reported outcomes after breast-conserving surgery and subcutaneous mastectomy with implant reconstruction for breast cancer. The observational comparison included 200 women older than 18 years: 115 underwent breast-conserving surgery and 85 underwent mastectomy with implant reconstruction. Satisfaction was assessed using the BREAST-Q questionnaire. Patients undergoing concurrent oncoplastic procedures or experiencing implant loss were excluded.

Breast-conserving surgery was associated with higher scores for psychosocial well-being (p < 0.001), sexual well-being (p = 0.002), and satisfaction with breast appearance (p < 0.001). The reconstruction group had higher proportions of patients younger than 50 years and with an ideal body mass index. Radiotherapy was received by 98% of the breast-conserving group versus approximately half of the reconstruction group. Smoking, radiotherapy, and chronic disease were associated with lower breast satisfaction in the reconstruction group; no demographic or clinical associations were reported in the breast-conserving group.

These findings may inform preoperative counseling about patient-reported outcomes, but do not establish that surgical choice caused the satisfaction differences. The abstract provides neither absolute BREAST-Q scores nor assessment timing, limiting interpretation of clinical magnitude. Group differences and exclusion of patients with implant loss also constrain applicability.