EMBARGOED FOR RELEASE UNTIL SEPTEMBER 20, 1997
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TRAM FLAP BREAST RECONSTRUCTION MAY PROVIDE GREATER PSYCHOSOCIAL OUTCOMES FOR PATIENTS
SAN FRANCISCO (September 20, 1997) ñ Women who choose breast reconstruction with autogenous tissue (tissue from the patient's own body) rather than implant may experience greater psychosocial outcomes, according to a study to be presented at the 66th Annual Meeting of the American Society of Plastic and Reconstructive Surgeons (ASPRS), September 20-24 in San Francisco, Calf. The prospective study, Part I of the Michigan Breast Reconstruction Outcome Study, was designed to measure the psychosocial outcomes of postmastectomy breast reconstruction. It includes evaluations of patients before and after reconstruction. Past research has been only retrospective, and did not include pre-operative evaluation.
"This new information strongly suggests that breast reconstruction makes a substantial contribution to the quality of a woman's life," said Edwin G. Wilkins, M.D., associate professor of surgery, University of Michigan, section of plastic surgery, and one of the authors of the study. "This needs to be a health benefit for American women."
The 99 consecutive patients evaluated at fourteen institutions selected either implant or transverse rectus abdominis myocutaneous (TRAM) flap reconstruction. Participants were administered a battery of validated questionnaires including the Medical Outcome Study Short Form and the Functional Assessment of Cancer Therapy before surgery and again one year after surgery.
A comparison of test results revealed that both the implant and TRAM flap patients showed statistically significant gains in psychosocial well-being in the areas of physical, social and emotional functioning, general mental health and vitality. In addition, the TRAM flap patients showed significant increases in the "ability to feel like a woman," improved body image, increased satisfaction with the fit of their clothing and overall "feelings of being whole" and "attractive," as compared to the implant patients.
"We wanted to know if the psychosocial outcomes would be better if the woman's own tissue was used in reconstruction, rather than an implant," said Dr. Wilkins. "While the TRAM flap patients had better outcomes, both groups made significant gains. The most important point is that breast reconstruction works for women who have had mastectomies."
The TRAM flap patients also noted more pain and tightness in the abdomen but less breast pain than the implant group. The two groups showed no statistically significant differences in general health, physical functioning and overall discomfort based on the type of reconstructive procedure.
The American Society of Plastic and Reconstructive Surgeons represents 97 percent of all physicians certified by the American Board of Plastic Surgery (ABPS). By choosing an ASPRS member plastic surgeon who is certified by the ABPS, patients can be assured that the physician has graduated from an accredited medical school and completed at least five years of additional residency, usually three years in general surgery and two years of plastic surgery. To be certified by the ABPS, a physician must also practice plastic surgery for two years and pass comprehensive written and oral examinations. Consumers may call Plastic Surgery Information Service at 1-800-635-0635 or access the ASPRS website at www.plasticsurgery.org for informational brochures and names of qualified plastic surgeons in their areas.
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