Evidence map›Paper›PMID 31136472›Full record

ArticlePlastic and reconstructive surgery2019

Impact of Unilateral versus Bilateral Breast Reconstruction on Procedure Choices and Outcomes.

Erin M Taylor, Edwin G Wilkins, Andrea L Pusic, Ji Qi, Hyungjin Myra Kim, Jennifer B Hamill, Gretchen E Guldbrandsen, Yoon S Chun

Open access · greenAbstract readComparative StudyEvaluation StudyMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Plastic and reconstructive surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 3 pooled it
2.7field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 3 syntheses or guidelines pooled it, 25 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Erin M TaylorFrom the Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital; the Section of Plastic Surgery and the Department of Biostatistics, University of Michigan Medical School; and the Memorial Sloan Kettering Cancer Center.
Edwin G WilkinsFrom the Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital; the Section of Plastic Surgery and the Department of Biostatistics, University of Michigan Medical School; and the Memorial Sloan Kettering Cancer Center.
Andrea L PusicFrom the Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital; the Section of Plastic Surgery and the Department of Biostatistics, University of Michigan Medical School; and the Memorial Sloan Kettering Cancer Center.
Ji QiFrom the Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital; the Section of Plastic Surgery and the Department of Biostatistics, University of Michigan Medical School; and the Memorial Sloan Kettering Cancer Center.
Hyungjin Myra KimFrom the Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital; the Section of Plastic Surgery and the Department of Biostatistics, University of Michigan Medical School; and the Memorial Sloan Kettering Cancer Center.
Jennifer B HamillFrom the Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital; the Section of Plastic Surgery and the Department of Biostatistics, University of Michigan Medical School; and the Memorial Sloan Kettering Cancer Center.
Gretchen E GuldbrandsenFrom the Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital; the Section of Plastic Surgery and the Department of Biostatistics, University of Michigan Medical School; and the Memorial Sloan Kettering Cancer Center.
Yoon S ChunFrom the Division of Plastic and Reconstructive Surgery, Brigham and Women's Hospital; the Section of Plastic Surgery and the Department of Biostatistics, University of Michigan Medical School; and the Memorial Sloan Kettering Cancer Center.
Memorial Sloan Kettering Cancer Center · US

Funding

X-RAY CRYSTALLOGRAPHYP30CA008748 · NCI · SLOAN-KETTERING INSTITUTE FOR CANCER RES · PI Nicholas D Socci · 1985 to 2026
$347.4M
Mastectomy Reconstruction Outcome Consortium (MROC Study)R01CA152192 · NCI · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI PUSIC, ANDREA LOUISE, WILKINS, EDWIN G. · 2011 to 2015
$4.9M
NCI NIH HHS P30 CA008748NCI NIH HHS R01 CA152192
6 · The paper itself

Abstract

backgroundIn choosing between implant-based and autologous breast reconstruction, surgeons and patients must weigh relative risks and benefits. However, differences in outcomes across procedure types may vary between unilateral versus bilateral reconstructions. Procedure-related differences in complications and patient-reported outcomes were evaluated for unilateral and bilateral reconstruction.

methodsComplications and patient-reported outcomes (BREAST-Q and Patient-Reported Outcomes measurement Information System surveys) were assessed at 2 years for patients undergoing autologous or implant-based reconstructions. Stratified regression models compared outcomes between autologous and implant-based reconstructions, separately for unilateral and bilateral cohorts.

resultsAmong 2125 patients, 917 underwent unilateral (600 implant and 317 autologous) and 1208 underwent bilateral (994 implant and 214 autologous) reconstructions. Complication rates were significantly higher in the autologous versus implant-based group for both unilateral (overall: OR, 2.50, p < 0.001; major: OR, 2.19, p = 0.001) and bilateral (overall: OR, 2.13, p < 0.001; major: OR, 1.69, p = 0.014) cohorts. In unilateral reconstruction, the autologous group demonstrated significantly better patient-reported outcomes versus implant-based group in satisfaction with breast (mean difference, 9.85; p < 0.001), psychosocial well-being (mean difference, 4.84; p = 0.006), and sexual well-being (mean difference, 11.42; p < 0.001). In bilateral reconstruction, the autologous group demonstrated significantly higher patient-reported outcomes only for satisfaction with breast (mean difference, 5.13; p = 0.001).

conclusionsAlthough autologous reconstruction is associated with significantly better patient-reported outcomes compared to implant-based techniques in unilateral reconstruction, procedure choice has far less impact in bilateral reconstruction. Autologous procedures have higher complications rates in both unilateral and bilateral settings. CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.

Indexed as

Surgical FlapsAutograftsBreast ImplantsBreast NeoplasmsClinical Decision-MakingFemaleHumansMammaplastyMastectomyMiddle AgedNipplesOrgan Sparing TreatmentsPatient Reported Outcome MeasuresPostoperative ComplicationsProspective StudiesTreatment Outcome

Identifiers

PMID31136472
PMCPMC6540808
OpenAlexW2962248272

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.