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Women who are not eligible for breast-conserving therapy frequently opt for reconstruction, but data on long-term health-related quality of life comparing different reconstructive surgeries is rare.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>REKO 001-trial is a single-center, three-arm study with a prospective longitudinal design and 10-year follow-up, investigating which surgery is associated with the highest quality of life. Between January 2017 and March 2022, 227 patients underwent either mastectomy (74), implant-based (77), or Deep Inferior Epigastric Perforator (DIEP) or Fascio-Cutaneous Infragluteal (FCI) free flap (76) reconstruction.<\/jats:p>\n                    <jats:p>This initial follow-up analysis compared HRQoL (BREAST-Q, FACT-B) and postoperative complications 5 months after surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The DIEP\/FCI group had the lowest preoperative BREAST-Q scores, but was the only group to show significant increases in many HRQoL domains within the first 5 months postoperatively. The mastectomy group showed significant decreases in some HRQoL domains. The implant-based group started with the highest BREAST-Q scores in most domains and had higher HRQoL scores than the mastectomy group. Radiotherapy and higher BMI significantly reduced HRQoL in some domains.<\/jats:p>\n                    <jats:p>The number of complications requiring inpatient treatment or reoperation within the first 5 months increased with extent of surgery (p\u2009=\u20090.037).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For patients opting for DIEP\/FCI reconstruction, an increase in HRQoL can be seen within the first 5 months after surgery, but they must accept the higher risk of complications and a decrease in abdominal well-being. Further follow-ups after 2, 5, 7, and 10 years are underway.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00404-026-08387-2","type":"journal-article","created":{"date-parts":[[2026,4,7]],"date-time":"2026-04-07T10:16:08Z","timestamp":1775556968000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Quality of life after breast (reconstructive) surgery\u2014an interim analysis of a prospective three-arm clinical trial with a 10-year follow-up\u00a0(REKO 001)"],"prefix":"10.1007","volume":"313","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5238-7521","authenticated-orcid":false,"given":"B.","family":"Boeer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Kandzi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B.","family":"Schoenfisch","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Marx","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Guergan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"I.","family":"Gruber","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"Roehm","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G.","family":"Helms","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Hartkopf","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. 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