A comparison of patient-reported outcomes after breast-conserving surgery and mastectomy with implant breast reconstruction Journal Article


Authors: Flanagan, M. R.; Zabor, E. C.; Romanoff, A.; Fuzesi, S.; Stempel, M.; Mehrara, B. J.; Morrow, M.; Pusic, A. L.; Gemignani, M. L.
Article Title: A comparison of patient-reported outcomes after breast-conserving surgery and mastectomy with implant breast reconstruction
Abstract: Background Many factors influence decisions regarding choice of breast-conserving surgery (BCS) versus mastectomy with reconstruction for early invasive breast cancer. The purpose of this study was to compare patient satisfaction following BCS and mastectomy with implant reconstruction (M-iR) utilizing the BREAST-Q patient-reported outcome measure. Methods Women with stage I or II breast cancer undergoing BCS or M-iR who completed a BREAST-Q from 2010 to 2016 were identified by retrospective review of a prospective database. Baseline characteristics were compared, and linear mixed models were used to analyze associations with BREAST-Q scores over time. Results Our study group was composed of 3233 women; 2026 (63%) had BCS, 123 (3.8%) had nipple-sparing mastectomy, and 1084 (34%) had skin-sparing or total mastectomy. Median time from surgery to BREAST-Q was 205 days for BCS and 639 days for M-iR (p < 0.001). Regardless of type of surgery, breast satisfaction scores decreased significantly over time (p < 0.001), whereas psychosocial (p = 0.001) and sexual (p = 0.004) well-being scores increased significantly over time. BCS was associated with significantly higher scores over time compared with M-iR across all subscales (all p < 0.001). Radiation was significantly associated with decreased scores over time across all subscales (all p < 0.05). Conclusions Breast satisfaction and quality-of-life scores were higher for BCS compared with M-iR in early-stage invasive breast cancer. These findings may help in counseling women who have a choice for surgical treatment. Breast satisfaction scores decreased over time in all women, highlighting the need for further evaluation with longer follow-up.
Keywords: radiation; radiotherapy; recurrence; health; therapy; women; quality-of-life; trends; metaanalysis; cancer
Journal Title: Annals of Surgical Oncology
Volume: 26
Issue: 10
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2019-10-01
Start Page: 3133
End Page: 3140
Language: English
ACCESSION: WOS:000484928300017
DOI: 10.1245/s10434-019-07548-9
PROVIDER: wos
PMCID: PMC6752888
PUBMED: 31342397
Notes: Source: Wos
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MSK Authors
  1. Monica Morrow
    477 Morrow
  2. Mary L Gemignani
    152 Gemignani
  3. Babak Mehrara
    267 Mehrara
  4. Emily Craig Zabor
    147 Zabor
  5. Michelle Moccio Stempel
    144 Stempel
  6. Sarah Fuzesi
    14 Fuzesi