{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T14:15:56Z","timestamp":1789395356378,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","issue":"18","license":[{"start":{"date-parts":[[2017,5,17]],"date-time":"2017-05-17T00:00:00Z","timestamp":1494979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Healthcare Quality Improvement Partnership"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2017,9,15]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Medical treatment for breast cancer is associated with substantial toxicity and patient burden. There is less known about the impact of surgical complications. Understanding this impact could provide important information for patients when they are considering surgical options.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>Between 2008 and 2009, the UK National Mastectomy and Breast Reconstruction Audit recorded surgical complications for a prospective cohort of 17,844 women treated for breast cancer at 270 hospitals; 6405 of these women were surveyed about their quality of life 18 months after surgery. Breast appearance, emotional well\u2010being, and physical well\u2010being were quantified on 0\u2010 to 100\u2010point scales. Linear multiple regression models, controlling for a range of baseline prognostic factors, were used to compare the scores of patients who had complications with the scores of those who did not.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>The overall complication rate was 10.2%. Complications were associated with little or no impairment in women undergoing mastectomy without reconstruction or with delayed reconstruction. The association was much larger for flap\u2010related complications suffered during immediate reconstruction. The breast\u2010appearance scores (adjusted mean difference, \u201323.8; 95% confidence interval [CI], \u201331.0 to \u201316.6) and emotional well\u2010being scores (adjusted mean difference, \u201314.0; 95% CI, \u201322.0 to \u20136.0) of these patients were much lower than those of any other patient group. Implant\u2010related complications were not associated with a lower quality of life in any surgical group.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>There is a strong case for prospectively collecting flap\u2010complication rates at the surgeon and surgical unit level and for allowing patients to access these data when they make choices about their breast cancer surgery. <jats:bold><jats:italic>Cancer<\/jats:italic> 2017;123:3460\u20107.<\/jats:bold> \u00a9 <jats:italic>2017 American Cancer Society<\/jats:italic>.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30788","type":"journal-article","created":{"date-parts":[[2017,5,17]],"date-time":"2017-05-17T11:02:45Z","timestamp":1495018965000},"page":"3460-3467","source":"Crossref","is-referenced-by-count":76,"title":["The association between complications and quality of life after mastectomy and breast reconstruction for breast cancer"],"prefix":"10.1002","volume":"123","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3494-4336","authenticated-orcid":false,"given":"John P.","family":"Browne","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Public Health University College Cork Cork Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ranjeet","family":"Jeevan","sequence":"additional","affiliation":[{"name":"Clinical Effectiveness Unit, Royal College of Surgeons of England London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmel","family":"Gulliver\u2010Clarke","sequence":"additional","affiliation":[{"name":"Integrated Breast Service, Western Sussex Hospitals National Health Service Foundation Trust Western Sussex United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of General Surgery James Paget University Hospitals National Health Service Foundation Trust Norfolk United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Caddy","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Sheffield Teaching Hospitals National Health Service Foundation Trust Sheffield United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan H. P.","family":"van der Meulen","sequence":"additional","affiliation":[{"name":"Department of Health Services Research Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,5,17]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2007.07.085"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-007224"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e318208d0d4"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/229255031402200216"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181aee807"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31823aec6b"},{"key":"e_1_2_8_8_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_8_9_1","unstructured":"Royal College of Surgeons.Documents and publications.https:\/\/www.rcseng.ac.uk\/standards-and-research\/research\/clinical-effectiveness-unit\/documents-and-publications\/. 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