{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T03:58:01Z","timestamp":1790740681467,"version":"4.1.0"},"reference-count":33,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T00:00:00Z","timestamp":1613347200000},"content-version":"vor","delay-in-days":193,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T00:00:00Z","timestamp":1596672000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T00:00:00Z","timestamp":1596672000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100003514","name":"Stockholm City Council for research","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003514","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Swedish Breast Cancer Association"},{"name":"Stockholm City Council for research"},{"name":"Swedish Breast Cancer Association"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2020,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Acellular dermal matrix (ADM) in implant-based breast reconstructions (IBBRs) aims to improve cosmetic outcomes. Six-month data are presented from a randomized trial evaluating whether IBBR with ADM provides higher health-related quality of life (HRQoL) and patient-reported cosmetic outcomes compared with conventional IBBR without ADM.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this multicentre open-label RCT, women with breast cancer planned for mastectomy with immediate IBBR in four centres in Sweden and one in the UK were allocated randomly (1 : 1) to IBBR with or without ADM. HRQoL, a secondary endpoint, was measured as patient-reported outcome measures (PROMs) using three validated instruments (EORTC-QLQC30, QLQ-BR23, QLQ-BRR26) at baseline and 6 months.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Between 24 April 2014 and 10 May 2017, 135 women were enrolled, of whom 64 with and 65 without ADM were included in the final analysis. At 6 months after surgery, patient-reported HRQoL, measured with generic QLQ-C30 or breast cancer-specific QLQ-BR23, was similar between the groups. For patient-reported cosmetic outcomes, two subscale items, cosmetic outcome (8\u00b766, 95 per cent c.i. 0\u00b746 to 16\u00b786; P\u00a0=\u00a00\u00b7041) and problems finding a well-fitting bra (\u221213\u00b721, \u221225\u00b754 to \u22120\u00b789; P\u00a0=\u00a00\u00b7038), yielded higher scores in favour of ADM, corresponding to a small to moderate clinical difference. None of the other 27 domains measured showed any significant differences between the groups.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>IBBR with ADM was not superior in terms of higher levels of HRQoL compared with IBBR without ADM. Although two subscale items of patient-reported cosmetic outcomes favoured ADM, the majority of cosmetic items showed no significant difference between treatments at 6 months. Registration number: NCT02061527 (www.clinicaltrials.gov).<\/jats:p>\n               <\/jats:sec>","DOI":"10.1002\/bjs5.50324","type":"journal-article","created":{"date-parts":[[2020,8,6]],"date-time":"2020-08-06T23:20:57Z","timestamp":1596756057000},"page":"811-820","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Quality of life and patient satisfaction after implant-based breast reconstruction with or without acellular dermal matrix: randomized clinical trial"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6299-0028","authenticated-orcid":false,"given":"F","family":"Lohmander","sequence":"first","affiliation":[{"name":"Department of Breast and Endocrine Surgery, Section of Breast Surgery, Karolinska University Hospital , Stockholm, Sweden"},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Lagergren","sequence":"additional","affiliation":[{"name":"Department of Surgery, Breast Centre, Capio St G\u00f6rans Hospital , Stockholm, Sweden"},{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Johansson","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2013Pathology, Cancer Centre, Karolinska Institutet , Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P G","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Breast Surgery, Oxford University Hospitals NHS Foundation Trust , Oxford, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Frisell","sequence":"additional","affiliation":[{"name":"Department of Molecular Medicine and Surgery, Karolinska Institutet , Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y","family":"Brandberg","sequence":"additional","affiliation":[{"name":"Department of Oncology\u2013Pathology, Cancer Centre, Karolinska Institutet , Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,8,6]]},"reference":[{"key":"2022100813161735800_bjs550324-bib-0001","volume-title":"National Quality Register for Breast Cancer","author":"Regionala Cancer Centrum","year":"2020"},{"key":"2022100813161735800_bjs550324-bib-0002","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1001\/jamasurg.2014.2895","article-title":"Nationwide trends in mastectomy for early-stage breast cancer","volume":"150","author":"Kummerow","year":"2015","journal-title":"JAMA Surg"},{"key":"2022100813161735800_bjs550324-bib-0003","volume-title":"2017 Cosmetic Plastic Surgery Statistics","author":"American Society of Plastic 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