Effect of modified radical mastectomy combined with latissimus dorsi musculocutaneous flap breast reconstruction on patients' psychology and quality of life

Background: Breast carcinoma (BC) is a commonly seen malignancy in women. Although traditional radical mastectomy can improve the survival of patients, it can cause breast loss and chest wall deformities, which seriously affects the daily life of patients and causes anxiety and depression. The purpose of this research project is to investigate the effect of breast reconstruction with latissimus dorsi myocutaneous flap (LDMF) after nipple- and areola-sparing modified radical mastectomy (MRM) on the psychological mood and quality of life (QoL) of patients with stage I BC. Methods: A total of 102 patients with BC (research group, RG) treated in the Shanghai Fifth People's Hospital, Fudan University from January 2018 to December 2020 were selected for phase I breast reconstruction with LDMF after nipple- and areola-sparing MRM. Concurrently, 50 BC patients (control group, CG) who underwent traditional total mastectomy in our hospital were collected. The activities of daily living (ADL), self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores were observed before and 1 month after treatment. The intraoperative indicators, postoperative complications, postoperative satisfaction rate and overall survival rate were compared. Results: The Functional Assessment of Cancer Therapy-Breast Cancer (FACT-B) score was higher after treatment, while SAS and SDS scores were lower in RG than in CG (P<0.05). No statistical difference was observed in intraoperative blood loss, wound drainage time, operation time, postoperative complications and overall survival rate between the two cohorts (P>0.05). RG showed higher satisfaction degree and overall satisfaction rate, as well as better QoL than CG (P<0.05). Conclusions: Breast reconstruction with LDMF after nipple- and areola-sparing MRM can alleviate adverse emotions of patients with stage I BC and improve their QoL.