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Introduction: Implant-based or expander-supported breast reconstruction is an established surgical method after mastectomies due to cancer or to prophylactic reasons. Patient reported outcome (PRO) and cosmetic outcome after breast reconstruction with a synthetic surgical mesh was investigated in a prospective, single-arm, multi-center study., Material and Methods: Primary or secondary implant-based breast reconstruction with support of TiLOOP® Bra was performed in 269 patients during the PRO-BRA study. PRO 12 months after breast reconstruction was evaluated using Breast-Q questionnaire. Cosmetic outcome was evaluated by two independent experts by means of pictures taken preoperatively and at the follow-up visits., Results: Breast-Q and 12 months FU were completed by 210 women. Patients without adverse event had a significantly higher Breast-Q score for "sexual well-being" (p = 0.001); "psychosocial well-being" was negatively influenced by prior therapies (p < 0.01), and older patients had significantly lower scores at 12 months FU compared to pre-OP for "satisfaction with breasts" (p < 0.01) while the opposite was true for younger patients. Unilateral surgery resulted in reduced "satisfaction with breast" at 12 months FU (p < 0.01). Radiotherapy negatively influenced "satisfaction with breast", "sexual well-being" and "physical well-being chest". The cosmetic evaluation showed a significant difference (p < 0.001) in the evaluation by the patients and experts with the patients' assessment being worse compared to experts' assessment., Conclusion: Our study showed that two years after implant-based breast reconstruction with support of TiLOOP® Bra PRO is influenced by different factors. This information can be used to improve the decision-making process for women who chose implant-based breast reconstruction., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: Within this study the improvement of life quality in patients after surgery for breast reduction should be evaluated., Material and Method: In total 70 patients, who had undergone an operation for breast reduction in the University Women's Hospital of Heidelberg from May 1998-June 2000, were chosen for this study. They were invited to an interview with three different standardized questionnaires concerning life quality. In total the questionnaires of 37 patients could be evaluated. They were about 12 months after operation., Results: It could be shown, that all patients had a significant improvement of their functional symptoms, the main part of them were totally free of symptoms after the operation. Most patients felt more female than before. They regarded themselves as more active, productive and sociable. This resulted in an improved self-confidence. In both groups the improvement was based mostly on a release of their functional complaints such as pain in th back or in the shoulders, but also on the psychological relief of the physical shame. The reduction of the breast masses, which were before well hidden by clothes, led to an improved self-confidence and self-assurance., Conclusion: Either women, who underwent the operation due to medical reasons, as well as women, who had mainly esthetic reasons for the operation, reach an improvement of life quality after surgery. The reached satisfaction of the patients and the improvement of life quality were absolutely independent from the weight of the resected tissue.

Ever since breast cancer has become looked upon as a local and simultaneously a systemic disease, local treatment has become ever less radical. Today, some 70% of all mamma carcinomas can be treated with breast-preserving techniques. Following pre-operative downstaging by primary neoadjuvant chemotherapy, even the majority of large tumors can be managed with conservative surgery. With the exception of ductal carcinoma in situ (DCIS) axillary lymph node clearance is currently standard practice. For an assessment of nodal status, at least 10 lymph nodes must be obtained and examined histologically. The sentinel lymph node biopsy performed under study conditions should be left to experienced specialized centers. Postoperative irradiation of the preserved breast is an element of the overall concept of breast-preserving surgery. The spectrum of surgical options covers breast-preserving procedures, skin-preserving mastectomy and amputation, which cannot always be avoided. With regard to plastic reconstruction, a differentiation should be made between the possibilities for reconstruction during primary surgery and reconstruction at a later date. Since postoperative radiotherapy can considerably diminish the results of reconstruction, current tendency is towards secondary reconstruction.