{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T09:18:29Z","timestamp":1787995109285,"version":"build-2784847793"},"reference-count":33,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"the federal government under the ALF agreement","award":["ALFGBG-1005048"],"award-info":[{"award-number":["ALFGBG-1005048"]}]},{"DOI":"10.13039\/501100002794","name":"Cancerfonden","doi-asserted-by":"publisher","award":["21 0279 SCIA"],"award-info":[{"award-number":["21 0279 SCIA"]}],"id":[{"id":"10.13039\/501100002794","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100005760","name":"g\u00f6teborgs universitet","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005760","id-type":"DOI","asserted-by":"publisher"}]},{"name":"BIBSAM"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Scand J Surg"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The aim of breast reconstruction after mastectomy is to improve quality of life and patient satisfaction, but cost-effectiveness of different reconstruction techniques remains uncertain due to methodological limitations in existing studies. High-quality trial-based economic evaluations are therefore needed. This study aimed to compare the quality of life and cost outcomes of patients randomized to different delayed breast reconstruction techniques based on previous receipt of radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A single-site randomized controlled trial (GoBreast; NCT03963427) including women aged 18\u201360 undergoing delayed breast reconstruction was conducted. Patients without previous radiotherapy were randomized to either thoracodorsal flap with implant (TD) or two-stage expander (EXP), while patients with previous receipt of radiotherapy were randomized to either latissimus dorsi with implant (LD) or deep inferior epigastric artery perforator (DIEP) flap. Outcomes included health-related quality of life (HRQoL) (by SF-6D utilities), re-operations, and direct\/indirect costs over long-term follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among patients without previous radiotherapy (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200975), EXP had slightly lower direct healthcare costs, but higher indirect costs, and generated a statistically significant positive change in HRQoL utility value (0.06 (0.02;0.9)) and fewer re-operations (2.34 vs 4.73) during a mean follow-up of 12.9\u2009years. Among patients who had received radiotherapy (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200925), there were no statistically significant differences in HRQoL utility scores or total costs, but a higher re-operation rate for LD as compared to DIEP.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Among patients without previous radiotherapy, EXP yielded superior HRQoL and fewer re-operations compared to TD. In patients with previous receipt of radiotherapy, DIEP reconstruction was associated with fewer re-operations and comparable costs compared to LD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/14574969261462051","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T11:21:32Z","timestamp":1782818492000},"page":"273-281","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Long-term study to assess quality of life and cost outcomes of different delayed breast reconstruction techniques: A randomized controlled trial (GoBreast)"],"prefix":"10.1177","volume":"115","author":[{"given":"Fredrik","family":"Brorson","sequence":"first","affiliation":[{"name":"Department of Plastic Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Plastic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3218-0881","authenticated-orcid":false,"given":"Emma","family":"Hansson","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery Institute of Clinical Sciences The Sahlgrenska Academy University of Gothenburg Gothenburg Sweden"},{"name":"Department of Plastic Surgery Sahlgrenska University Hospital R\u00f6da Str\u00e5ket 12 Gothenburg SE-413 45 Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Paganini","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Plastic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden"},{"name":"Department of Diagnostics, Acute and Critical Care, Institute of Health and Care Sciences, Sahlgrenska Academy at the University of Gothenburg, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Elander","sequence":"additional","affiliation":[{"name":"Department of Plastic Surgery, Institute of Clinical Sciences, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"},{"name":"Department of Plastic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikael","family":"Svensson","sequence":"additional","affiliation":[{"name":"School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1055\/a-1424-1428"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9883"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000000004"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.2340\/jphs.v59.19649"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.2340\/jphs.v59.40087"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clbc.2022.09.004"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2020.07.010"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2021-067975"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41591-025-03635-5"},{"key":"e_1_3_3_11_2","unstructured":"Elander A Lundberg J Karlsson P et al: Indikation f\u00f6r br\u00f6strekonstruktion med kroppsegen v\u00e4vnad med fri lamb\u00e5. Nationella medicinska indikationer Stockholm 2011."},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-198606000-00010"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0b013e31818b89da"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1097\/00006534-197901000-00006"},{"issue":"3","key":"e_1_3_3_15_2","first-page":"423","article-title":"The free abdominoplasty flap and its use in breast reconstruction. An experimental study and clinical case report","volume":"13","author":"Holmstr\u00f6m H","year":"1979","unstructured":"Holmstr\u00f6m H. The free abdominoplasty flap and its use in breast reconstruction. An experimental study and clinical case report. Scand J Plast Reconstr Surg 1979;13(3):423\u2013427.","journal-title":"Scand J Plast Reconstr Surg"},{"key":"e_1_3_3_16_2","volume-title":"European Observatory on Health Systems and Policies","author":"Janl\u00f6v N","year":"2024","unstructured":"Janl\u00f6v N, Merkur S. European Observatory on Health Systems and Policies. World Health Organization, Geneva, 2024."},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/1467-9477.12262"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/hec.4730020305"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0167-6296(01)00130-8"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40258-024-00919-8"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-199610050-00003"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2004.09.011"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2020.11.130"},{"issue":"10","key":"e_1_3_3_24_2","article-title":"Cost-effectiveness analysis of abdominal-based autogenous tissue and tissue-expander implant following mastectomy","volume":"8","author":"Thoma A","year":"2020","unstructured":"Thoma A, Avram R, Dal Cin A, et al: Cost-effectiveness analysis of abdominal-based autogenous tissue and tissue-expander implant following mastectomy. Plast Reconstr Surg Glob Open 2020;8(10):e2986.","journal-title":"Plast Reconstr Surg Glob Open"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-022-12619-5"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.prs.0000479935.92904.a3"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1586\/14737167.8.2.165"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39308.560069.BE"},{"key":"e_1_3_3_29_2","volume-title":"H\u00e4lsoekonomisk utv\u00e4rdering: Metod och till\u00e4mpningar, Upplaga 1 ed","author":"Svensson M","year":"2019","unstructured":"Svensson M. H\u00e4lsoekonomisk utv\u00e4rdering: Metod och till\u00e4mpningar, Upplaga 1 ed. Studentlitteratur, Lund, 2019."},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(98)00151-6"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000004362"},{"key":"e_1_3_3_32_2","doi-asserted-by":"publisher","DOI":"10.3310\/hta18090"},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1097\/PRS.0000000000001134"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vhri.2020.02.001"}],"container-title":["Scandinavian Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14574969261462051","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/14574969261462051","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/14574969261462051","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T08:47:17Z","timestamp":1787993237000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/14574969261462051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":33,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1177\/14574969261462051"],"URL":"https:\/\/doi.org\/10.1177\/14574969261462051","relation":{},"ISSN":["1457-4969","1799-7267"],"issn-type":[{"value":"1457-4969","type":"print"},{"value":"1799-7267","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]}}}