Timing of chemotherapy and patient-reported outcomes after breast-conserving surgery and mastectomy with immediate reconstruction Journal Article
| Authors: | Pawloski, K. R.; Srour, M. K.; Moo, T. A.; Sevilimedu, V.; Nelson, J. A.; Garcia, P.; Kirstein, L. J.; Morrow, M.; Tadros, A. B. |
| Article Title: | Timing of chemotherapy and patient-reported outcomes after breast-conserving surgery and mastectomy with immediate reconstruction |
| Abstract: | Introduction: Receipt of chemotherapy is associated with decreased satisfaction after breast surgery, but whether timing as adjuvant versus neoadjuvant (NAC) affects patient-reported outcomes (PROs) is unclear. We examined associations between chemotherapy timing and PROs after breast-conserving surgery (BCS) and mastectomy with immediate reconstruction (M-IR). Methods: In this retrospective cohort study of patients with stage I-III breast cancer undergoing chemotherapy between January 2017 and December 2019, we compared satisfaction with breasts (SABTR) and chest physical well-being (PWB-CHEST) between chemotherapy groups in BCS and M-IR cohorts. Median SABTR and PWB-CHEST scores (scale 0–100) were compared between chemotherapy groups at baseline and for 3 years postoperatively. Factors associated with SABTR and PWB-CHEST at 1 and 2 years were assessed with multivariable linear regression. Results: Overall, 640 patients had BCS and 602 had M-IR; 210 (33%) BCS patients and 294 (49%) M-IR patients had NAC. Following BCS, SABTR was higher than baseline at all postoperative timepoints, whereas 3-year SABTR remained similar to baseline following M-IR, independent of chemotherapy timing. In both surgical cohorts, PWB-CHEST was lowest after NAC at 6 months compared with baseline but was similar to adjuvant counterparts by 3 years. NAC was not a statistically significant predictor of SABTR or PWB-CHEST in either surgical cohort on multivariable analysis. Conclusions: For patients with breast cancer who require chemotherapy, neoadjuvant versus adjuvant timing does not impact long-term PROs in this study. These findings may inform shared decision making regarding the sequence of treatment in patients with operable disease. © 2023, Society of Surgical Oncology. |
| Keywords: | retrospective studies; mastectomy; breast neoplasms; breast reconstruction; mammaplasty; retrospective study; breast tumor; partial mastectomy; patient reported outcome measures; mastectomy, segmental; patient-reported outcome; humans; human; female |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 30 |
| Issue: | 5 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2023-05-01 |
| Start Page: | 2897 |
| End Page: | 2909 |
| Language: | English |
| DOI: | 10.1245/s10434-023-13148-5 |
| PUBMED: | 36737530 |
| PROVIDER: | scopus |
| PMCID: | PMC11110643 |
| DOI/URL: | |
| Notes: | Article -- Export Date: 1 May 2023 -- Source: Scopus |
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