Patient-reported outcome measures for patients who have clinical T4 breast cancer treated via mastectomy with and without reconstruction Journal Article
| Authors: | Palmquist, E.; Limberg, J.; Chu, J. J.; White, C.; Baser, R. E.; Sevilimedu, V.; Pawloski, K. R.; Garcia, P.; Nelson, J. A.; Moo, T. A.; Morrow, M.; Tadros, A. B. |
| Article Title: | Patient-reported outcome measures for patients who have clinical T4 breast cancer treated via mastectomy with and without reconstruction |
| Abstract: | 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: 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: 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: 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. © 2022, Society of Surgical Oncology. |
| Keywords: | adult; controlled study; patient satisfaction; cancer surgery; retrospective studies; major clinical study; postoperative period; cancer patient; cancer staging; outcome assessment; preoperative evaluation; quality of life; breast cancer; mastectomy; cohort analysis; breast neoplasms; breast reconstruction; retrospective study; distant metastasis; breast tumor; patient reported outcome measures; decision making; prophylactic mastectomy; patient-reported outcome; reconstructive surgery; breast-q; humans; human; female; article; physical well-being; social well-being |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 30 |
| Issue: | 1 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2023-01-01 |
| Start Page: | 115 |
| End Page: | 121 |
| Language: | English |
| DOI: | 10.1245/s10434-022-12560-7 |
| PUBMED: | 36149609 |
| PROVIDER: | scopus |
| PMCID: | PMC10128102 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF. Corresponding author is MSK author Audree B. Tadros -- Export Date: 3 January 2023 -- Source: Scopus |
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