Annelotte van Bommel

154 Multivariate analyses of patient-reported outcomes in patients with and without IBR All BREAST-Q outcomes showed a normal distribution with the mean and median closely related, enabling linear regression modeling. Confounding factors included in the multivariate model were age, socio-economic status, employment status, comorbidities, BMI, breast cancer stage and radiotherapy. IBR proved to be independently associated (p<0.001) with favorable “psychosocial” and “sexual well-being” BREAST-Q domain scores and showed a borderline association with “physical well-being” (p=0.049). IBR did not appear to be significantly associated with the BREAST-Q domain “satisfaction with breasts” (p=0.483). For “psychosocial well-being” and “sexual well-being”, no other independently associated factors were found in multivariate linear regression analyses. Younger age and a higher tumor stage were independently associated with “satisfaction with breasts” and the presence of multiple comorbidities was independently associated with “physical functioning”. DISCUSSION The present study investigated health-related quality of life of patients with and without IBR following mastectomy. After adjusting for confounding factors, IBR was associated with significantly better BREAST-Q outcomes for “psychosocial functioning”, “sexual functioning” and “physical functioning” compared to patients without IBR. Interestingly, no statistically significant differences were found for the BREAST-Q domain “satisfaction with breasts”. Overall, the results of this reasonably large, and representative sample of more than 400 breast cancer patients in the Netherlands underscore the importance that all patients with an indication for mastectomy should be offered the possibility of IBR in order to achieve favorable quality of life outcomes and to enable shared decision-making. Ultimately, it is up to the patient, together with her clinician, to decide whether or not IBR is preferred or feasible. Breast cancer survival rates are high, enabling and demanding a shift of focus towards quality of life after cancer treatment. Mastectomy still has a prominent