{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,16]],"date-time":"2026-08-16T18:25:19Z","timestamp":1786904719090,"version":"build-2736575974"},"reference-count":30,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Surgical Oncology"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>BREAST\u2010Q is the most widely used patient\u2010reported outcome measure following breast reconstruction, yet no consensus exists on optimal timing or duration of administration. We analyzed BREAST\u2010Q follow\u2010up after implant\u2010based reconstruction, comparing direct\u2010to\u2010implant (DTI) and two\u2010stage tissue expander (TE), to determine how outcomes differ over time and when they stabilize.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Following PRISMA guidelines, PubMed, Embase, Cochrane, Ovid, and Web of Science were searched for studies administering BREAST\u2010Q after implant\u2010based reconstruction. Random\u2010effects meta\u2010analysis and meta\u2010regression compared pooled mean scores across five domains from preoperative baseline through 2\u2009years postoperatively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Fourteen studies, including 3768 patients, met the inclusion criteria. Among TE patients, psychosocial well\u2010being was higher at 12\u201316\u2009months than at baseline (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.022), whereas physical well\u2010being was below baseline within the first 6\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.028). Among DTI patients, physical well\u2010being increased between 3 and 6 and 12\u201316\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048), then declined by 18\u201324\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.031), while sexual well\u2010being improved by 12\u201316\u2009months and remained elevated through 18\u201324\u2009months (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.026 and\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.045). Pooled scores did not differ significantly between TE and DTI in any domain.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BREAST\u2010Q outcomes remain dynamic during the first 2 postoperative years, supporting follow\u2010up through at least 18\u201324\u2009months to better capture long\u2010term patient\u2010reported outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jso.70374","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T18:59:59Z","timestamp":1786388399000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Timing Matters: A Meta\u2010Analysis of BREAST\u2010Q Administration in Tissue\u2010Expander and Implant\u2010Based Breast Reconstruction"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1000-1507","authenticated-orcid":false,"given":"Emanuella M.","family":"Brito","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland Ohio USA"},{"name":"Department of Surgery Dr. Kiran C Patel College of Osteopathic Medicine, NSU Fort Lauderdale Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel","family":"Bernal","sequence":"additional","affiliation":[{"name":"Department of Surgery Westside Hospital Plantation Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sean K.","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia L.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Surgery Dr. Kiran C Patel College of Osteopathic Medicine, NSU Fort Lauderdale Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2468-9363","authenticated-orcid":false,"given":"Natalia","family":"Correa","sequence":"additional","affiliation":[{"name":"Department of Surgery Holy Cross Hospital Fort Lauderdale Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony","family":"Pasarin","sequence":"additional","affiliation":[{"name":"Department of Surgery Westside Hospital Plantation Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anastasia","family":"Tousimis","sequence":"additional","affiliation":[{"name":"Department of Surgery Baptist Health South Florida Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graham S.","family":"Schwarz","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin I.","family":"Newman","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Cleveland Clinic Weston Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e3181aee807"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000001904"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2015.11.013"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2018.1677"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.2147\/BCTT.S256393"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2023.06.054"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000004245"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000003748"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000000533"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2018.12.018"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2018.02.001"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-022-03121-0"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjsopen\/zraa063"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1159\/000505449"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000011092"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2340\/jphs.v59.18622"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30378-4"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamasurg.2022.7625"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjps.2023.06.027"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000008506"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.815498"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00266-021-02584-x"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1111\/ecc.13686"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-022-11504-5"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.breast.2024.103832"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5415"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-022-11521-4"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2016.69.9561"},{"key":"e_1_2_8_30_1","doi-asserted-by":"publisher","DOI":"10.1097\/GOX.0000000000004420"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/tbj.14070"}],"container-title":["Journal 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