Patient satisfaction after breast cancer surgery : A prospective clinical trial.
Breast analyzing tool
Breast cancer
Cosmetic results
Oncoplastic breast surgery
Quality of life
Journal
Wiener klinische Wochenschrift
ISSN: 1613-7671
Titre abrégé: Wien Klin Wochenschr
Pays: Austria
ID NLM: 21620870R
Informations de publication
Date de publication:
Jan 2021
Jan 2021
Historique:
received:
26
02
2020
accepted:
03
08
2020
pubmed:
4
9
2020
medline:
30
1
2021
entrez:
4
9
2020
Statut:
ppublish
Résumé
This study investigated the impact of curative breast cancer surgery on patient satisfaction concerning cosmetic results and quality of life (QoL). In this study 61 participants completed questionnaires to evaluate their QoL and patient satisfaction with cosmetic results following breast cancer surgery. Cosmetic outcomes were evaluated by the breast surgeon and an independent breast specialist using the Harris scale and the breast analyzing tool (BAT). Of the participants 71% completed all 4 follow-up visits, 38 (62%) patients received breast-conserving therapy (BCT) and 23 (38%) received a mastectomy. Surgery-associated complications arose in 2.6% of the patients who received BCT and 17.4% of patients who received a mastectomy. No significant differences in QoL between BCT patients and mastectomy patients were observed immediately after surgery, or after 6 and 12 months. Breast asymmetry, measured using the BAT score, and QoL scores were worst immediately after surgery. The surgeon rated the cosmetic results as better compared to the independent breast expert (p = 0.001). Furthermore, patients aged over 60 years old were less satisfied with the cosmetic outcome compared to younger patients at the time of discharge (p = 0.024). Patients who received a mastectomy were less satisfied when the resected volume was higher. Patient satisfaction was lowest immediately after surgery but improved during the following months, despite continued breast asymmetry. For mastectomy patients, a lower resected volume led to a higher satisfaction with cosmetic results. Satisfaction is subjective and cannot be determined from the esthetic satisfaction of the surgeon or using an objective tool measuring breast asymmetry.
Sections du résumé
BACKGROUND
BACKGROUND
This study investigated the impact of curative breast cancer surgery on patient satisfaction concerning cosmetic results and quality of life (QoL).
METHODS
METHODS
In this study 61 participants completed questionnaires to evaluate their QoL and patient satisfaction with cosmetic results following breast cancer surgery. Cosmetic outcomes were evaluated by the breast surgeon and an independent breast specialist using the Harris scale and the breast analyzing tool (BAT).
RESULTS
RESULTS
Of the participants 71% completed all 4 follow-up visits, 38 (62%) patients received breast-conserving therapy (BCT) and 23 (38%) received a mastectomy. Surgery-associated complications arose in 2.6% of the patients who received BCT and 17.4% of patients who received a mastectomy. No significant differences in QoL between BCT patients and mastectomy patients were observed immediately after surgery, or after 6 and 12 months. Breast asymmetry, measured using the BAT score, and QoL scores were worst immediately after surgery. The surgeon rated the cosmetic results as better compared to the independent breast expert (p = 0.001). Furthermore, patients aged over 60 years old were less satisfied with the cosmetic outcome compared to younger patients at the time of discharge (p = 0.024). Patients who received a mastectomy were less satisfied when the resected volume was higher.
CONCLUSION
CONCLUSIONS
Patient satisfaction was lowest immediately after surgery but improved during the following months, despite continued breast asymmetry. For mastectomy patients, a lower resected volume led to a higher satisfaction with cosmetic results. Satisfaction is subjective and cannot be determined from the esthetic satisfaction of the surgeon or using an objective tool measuring breast asymmetry.
Identifiants
pubmed: 32880714
doi: 10.1007/s00508-020-01730-w
pii: 10.1007/s00508-020-01730-w
pmc: PMC7840629
doi:
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
6-13Références
Didie ER, Sarwer DB. Factors that influence the decision to undergo cosmetic breast augmentation surgery. J Womens Health. 2003;12:241–53.
doi: 10.1089/154099903321667582
Sarwer DB, Magee L, Clark V. Physical appearance and cosmetic medical treatments: physiological and socio-cultural influences. J Cosmet Dermatol. 2003;2:29–39.
doi: 10.1111/j.1473-2130.2003.00003.x
Glanz K, Lerman C. Psychosocial impact of breast cancer: a critical review. Ann Behav Med. 1992;14:204–12.
Yurek D, Farrar W, Andersen BL. Breast cancer surgery: Comparing surgical groups and determining individual differences in postoperative sexuality and body change stress. J Consult Clin Psychol. 2000;68:697.
doi: 10.1037/0022-006X.68.4.697
Ashing-Giwa KT, Padilla G, Tejero J, Kraemer J, Wright K, Coscarelli A, et al. Understanding the breast cancer experience of women: a qualitative study of African American, Asian American, Latina and Caucasian cancer survivors. Psychooncology. 2004;13:408–28.
doi: 10.1002/pon.750
Al-Ghazal S, Fallowfield L, Blamey R. Comparison of psychological aspects and patient satisfaction following breast conserving surgery, simple mastectomy and breast reconstruction. Eur J Cancer. 2000;36:1938–43.
doi: 10.1016/S0959-8049(00)00197-0
Harcourt DM, Rumsey NJ, Ambler NR, Cawthorn SJ, Reid CD, Maddox PR, et al. The psychological effect of mastectomy with or without breast reconstruction: a prospective, multicenter study. Plast Reconstr Surg. 2003;111:1060–8.
doi: 10.1097/01.PRS.0000046249.33122.76
Zhang H, Li Y, Moran MS, Haffty BG, Yang Q. Predictive factors of nipple involvement in breast cancer: a systematic review and meta-analysis. Breast Cancer Res Treat. 2015;151:239–49.
doi: 10.1007/s10549-015-3385-4
Munhoz AM, Montag E, Filassi JR, Gemperli R. Immediate nipple-areola-sparing mastectomy reconstruction: an update on oncological and reconstruction techniques. World J Clin Oncol. 2014;5:478–94.
doi: 10.5306/wjco.v5.i3.478
Fitzal F, Krois W, Trischler H, Wutzel L, Riedl O, Kühbelböck U, et al. The use of a breast symmetry index for objective evaluation of breast cosmesis. Breast. 2007;16:429–35.
doi: 10.1016/j.breast.2007.01.013
Herschbach P, Marten-Mittag B, Henrich G. Revision und psychometrische Prüfung des Fragebogen zur Belastung von Krebskranken (FBK-R23). Z Med Psychol. 2003;12:69–76.
Fayers P, Bottomley AO, Group EQoL. Quality of life research within the EORTC—the EORTC QLQ-C30. Eur J Cancer. 2002;38:125–33.
doi: 10.1016/S0959-8049(01)00448-8
Härtl K, Janni W, Kästner R, Sommer H, Strobl B, Rack B, et al. Impact of medical and demographic factors on long-term quality of life and body image of breast cancer patients. Ann Oncol. 2003;14:1064–71.
doi: 10.1093/annonc/mdg289
Cassileth L, Kohanzadeh S, Amersi F. One-stage immediate breast reconstruction with implants: a new option for immediate reconstruction. Ann Plast Surg. 2012;69:134–8.
doi: 10.1097/SAP.0b013e3182250c60
Ganz PA, Rowland JH, Desmond K, Meyerowitz BE, Wyatt GE. Life after breast cancer: understanding women’s health-related quality of life and sexual functioning. J Clin Oncol. 1998;16:501–14.
doi: 10.1200/JCO.1998.16.2.501
Shimozuma K, Ganz PA, Petersen L, Hirji K. Quality of life in the first year after breast cancer surgery: rehabilitation needs and patterns of recovery. Breast Cancer Res Treat. 1999;56:45–57.
doi: 10.1023/A:1006214830854
Henderson VP, Clemow L, Massion AO, Hurley TG, Druker S, Hébert JR. The effects of mindfulness-based stress reduction on psychosocial outcomes and quality of life in early-stage breast cancer patients: a randomized trial. Breast Cancer Res Treat. 2012;131:99–109.
doi: 10.1007/s10549-011-1738-1
Exner R, Krois W, Mittlbock M, Dubsky P, Jakesz R, Gnant M, et al. Objectively measured breast symmetry has no influence on quality of life in breast cancer patients. Eur J Surg Oncol. 2012;38:130–6.
doi: 10.1016/j.ejso.2011.10.012
Kim MK, Kim T, Moon HG, Jin US, Kim K, Kim J, et al. Effect of cosmetic outcome on quality of life after breast cancer surgery. Eur J Surg Oncol. 2015;41:426–32.
doi: 10.1016/j.ejso.2014.12.002
Kissane DW, Grabsch B, Clarke DM, Smith GC, Love AW, Bloch S, et al. Supportive-expressive group therapy for women with metastatic breast cancer: Survival and psychosocial outcome from a randomized controlled trial. Psychooncology. 2007;16:277–86.
doi: 10.1002/pon.1185
Burkheimer E, Starks L, Khan M, Oostendorp L, Melnik MK, Chung MH, et al. The impact of obesity on treatment choices and outcomes in operable breast cancer. Am J Surg. 2019;217(3):474–7.
doi: 10.1016/j.amjsurg.2018.10.048