Patient-Reported Outcome Measures for Patients Who Have Clinical T4 Breast Cancer Treated via Mastectomy with and Without Reconstruction.
Journal
Annals of surgical oncology
ISSN: 1534-4681
Titre abrégé: Ann Surg Oncol
Pays: United States
ID NLM: 9420840
Informations de publication
Date de publication:
Jan 2023
Jan 2023
Historique:
received:
29
06
2022
accepted:
03
09
2022
pmc-release:
01
01
2024
pubmed:
24
9
2022
medline:
15
12
2022
entrez:
23
9
2022
Statut:
ppublish
Résumé
Patients with clinical T4M0 breast cancer are recommended to undergo neoadjuvant chemotherapy, modified radical mastectomy, and postmastectomy radiotherapy. This study determined whether BREAST-Q scores differ by decision to pursue reconstruction or timing of reconstruction. This retrospective, single-institutional study analyzed cT4 breast cancer patients from 2014 to 2021 without evidence of distant metastatic disease undergoing mastectomy with or without reconstruction. As routine care, BREAST-Q was administered preoperatively, then 6 months, 1 year, and 2 years postoperatively. Satisfaction and quality-of-life domains were compared between mastectomy with no reconstruction (NR), immediate reconstruction (IR), and delayed reconstruction (DR) groups. Of the 144 patients eligible for this study, 71 (49%) had NR, 36 (25%) had DR, and 37 (26%) had IR. The patients undergoing reconstruction were younger and more likely to elect contralateral prophylactic mastectomy. Timing of reconstruction was not associated with significant differences in satisfaction with breasts (SATBR) at any time point. For the patients who had DR, breast satisfaction increased over time after reconstructive surgery. Physical well-being of the chest (PWB-CHEST) did not significantly differ among IR, DR, and NR at any time point. The patients who underwent DR experienced improvement in PWB-CHEST scores from preoperative scores. The patients with IR and NR experienced PWB-CHEST decline over time. Psychosocial well-being (PSWB) did not differ significantly across time or by subgroup. The patients with T4 breast cancer who elected reconstruction did not differ in patient-reported outcomes based on timing of reconstruction. In the DR cohort, SATBR significantly improved after reconstructive surgery. These data can help inform breast reconstructive decision-making for patients facing the choice among DR, IR, and NR.
Sections du résumé
BACKGROUND
BACKGROUND
Patients with clinical T4M0 breast cancer are recommended to undergo neoadjuvant chemotherapy, modified radical mastectomy, and postmastectomy radiotherapy. This study determined whether BREAST-Q scores differ by decision to pursue reconstruction or timing of reconstruction.
METHODS
METHODS
This retrospective, single-institutional study analyzed cT4 breast cancer patients from 2014 to 2021 without evidence of distant metastatic disease undergoing mastectomy with or without reconstruction. As routine care, BREAST-Q was administered preoperatively, then 6 months, 1 year, and 2 years postoperatively. Satisfaction and quality-of-life domains were compared between mastectomy with no reconstruction (NR), immediate reconstruction (IR), and delayed reconstruction (DR) groups.
RESULTS
RESULTS
Of the 144 patients eligible for this study, 71 (49%) had NR, 36 (25%) had DR, and 37 (26%) had IR. The patients undergoing reconstruction were younger and more likely to elect contralateral prophylactic mastectomy. Timing of reconstruction was not associated with significant differences in satisfaction with breasts (SATBR) at any time point. For the patients who had DR, breast satisfaction increased over time after reconstructive surgery. Physical well-being of the chest (PWB-CHEST) did not significantly differ among IR, DR, and NR at any time point. The patients who underwent DR experienced improvement in PWB-CHEST scores from preoperative scores. The patients with IR and NR experienced PWB-CHEST decline over time. Psychosocial well-being (PSWB) did not differ significantly across time or by subgroup.
CONCLUSIONS
CONCLUSIONS
The patients with T4 breast cancer who elected reconstruction did not differ in patient-reported outcomes based on timing of reconstruction. In the DR cohort, SATBR significantly improved after reconstructive surgery. These data can help inform breast reconstructive decision-making for patients facing the choice among DR, IR, and NR.
Identifiants
pubmed: 36149609
doi: 10.1245/s10434-022-12560-7
pii: 10.1245/s10434-022-12560-7
pmc: PMC10128102
mid: NIHMS1886604
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
115-121Subventions
Organisme : NCI NIH HHS
ID : P30 CA008748
Pays : United States
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022. Society of Surgical Oncology.
Références
J Natl Cancer Inst. 2018 Feb 1;110(2):
pubmed: 28954300
Ann Surg Oncol. 2021 May;28(5):2493-2505
pubmed: 33393025
Plast Reconstr Surg. 2017 Jun;139(6):1279-1288
pubmed: 28198770
Plast Reconstr Surg. 2012 Feb;129(2):293-302
pubmed: 22286412
Lancet Oncol. 2022 May;23(5):682-690
pubmed: 35397804
Ann Oncol. 2011 Mar;22(3):515-523
pubmed: 20603440
Ann Surg Oncol. 2020 Jul;27(7):2238-2247
pubmed: 31965369
Surgery. 2016 Oct;160(4):1059-1069
pubmed: 27521042
Cancer. 1984 Feb 1;53(3 Suppl):752-7
pubmed: 6692275
Ann Surg. 2019 Sep;270(3):473-483
pubmed: 31356276
Breast J. 2020 Mar;26(3):384-390
pubmed: 31448540
J Am Coll Surg. 2021 Aug;233(2):285-293
pubmed: 33957258
Ann Surg Oncol. 1999 Oct-Nov;6(7):671-5
pubmed: 10560853
Breast Cancer Res Treat. 2019 Jul;176(2):337-347
pubmed: 31020469
J Clin Oncol. 2016 May 1;34(13):1518-27
pubmed: 26951322
Plast Reconstr Surg. 2020 Jan;145(1):11e-20e
pubmed: 31577663
Plast Reconstr Surg. 2009 Aug;124(2):345-353
pubmed: 19644246
CA Cancer J Clin. 2010 Nov-Dec;60(6):351-75
pubmed: 20959401