Objectives:Breast cancer treatment has increasingly shifted toward integrating patient-reported outcomes into surgical decision-making. However, Romania has lacked a validated instrument to evaluate quality of life (QoL) after breast reconstruction. This study aimed to translate, culturally adapt, and clinically validate the Romanian version of the BREAST-Q Reconstruction Module, and to assess postoperative changes in QoL following immediate and delayed breast reconstruction.Methods:A prospective observational study enrolled 116 patients undergoing immediate or delayed implant-based or autologous reconstruction between June 2023 and June 2024. The BREAST-Q was translated using standardized forward–backward methodology, followed by expert review, pilot testing, and psychometric validation. Patients completed preoperative and 1-year postoperative BREAST-Q questionnaires. Statistical analyses included Cronbach’s α, intraclass correlation coefficients, paired and independentt-tests, Pearson correlations, and ANCOVA to assess the impact of radiotherapy and other clinical factors on postoperative outcomes.Results:The Romanian BREAST-Q showed excellent internal consistency (α = 0.947) and strong test–retest reliability (ICC = 0.81–0.92). Both immediate and delayed reconstruction significantly improved psychosocial well-being and breast symptoms (p < 0.001). Immediate reconstruction produced modest gains in physical well-being, whereas delayed reconstruction yielded a substantial increase in breast satisfaction (effect size d = 1.33). Breast sensation significantly decreased in both cohorts. Within delayed reconstructions, deep inferior epigastric perforator (DIEP) flaps were associated with higher physical well-being, whereas latissimus dorsi (LD) flaps demonstrated slightly better sensory outcomes. Radiotherapy had a strong negative effect on postoperative breast satisfaction (p < 0.001) after adjusting for covariates.Conclusions:The Romanian BREAST-Q is a valid, reliable instrument for evaluating QoL after breast reconstruction. Reconstruction improved multiple QoL domains, although sensory decline persisted across techniques. Symmetrization and DIEP reconstruction enhanced postoperative comfort, while radiotherapy remained a major predictor of lower satisfaction. These findings support the need for integrative reconstructive strategies that address aesthetic, functional, and sensory outcomes.
目的：乳腺癌治疗日益倾向于将患者报告结局纳入手术决策。然而，罗马尼亚此前缺乏经过验证的工具来评估乳房重建术后的生活质量。本研究旨在对BREAST-Q乳房重建模块进行罗马尼亚语版本的翻译、文化调适及临床验证，并评估即刻与延期乳房重建术后生活质量的变化。 方法：这项前瞻性观察研究纳入了2023年6月至2024年6月期间接受即刻或延期假体/自体组织乳房重建的116例患者。采用标准化正向-逆向翻译流程完成BREAST-Q量表的翻译，随后进行专家评审、预试验及心理测量学验证。患者于术前及术后1年完成BREAST-Q问卷调查。统计分析包括克朗巴赫α系数、组内相关系数、配对与独立样本t检验、皮尔逊相关分析及协方差分析，以评估放疗及其他临床因素对术后结局的影响。 结果：罗马尼亚语版BREAST-Q显示出优异的内部一致性（α=0.947）和较强的重测信度（ICC=0.81-0.92）。即刻与延期重建均显著改善了心理社会健康及乳房症状（p<0.001）。即刻重建在身体健康方面提升有限，而延期重建则显著提高了乳房满意度（效应量d=1.33）。两组患者的乳房感觉均显著下降。在延期重建组中，腹壁下动脉穿支皮瓣与更高的身体健康水平相关，而背阔肌皮瓣在感觉恢复方面表现略优。校正协变量后，放疗对术后乳房满意度存在显著负面影响（p<0.001）。 结论：罗马尼亚语版BREAST-Q是评估乳房重建术后生活质量的有效可靠工具。尽管各类重建技术均存在感觉功能下降，但重建手术能改善多维度生活质量。对称性手术与腹壁下动脉穿支皮瓣重建可提升术后舒适度，而放疗仍是导致满意度降低的主要预测因素。这些发现表明需要制定兼顾美学、功能与感觉结局的综合性重建策略。
肿瘤(癌症)患者之家