The impact of lymphedema on patient-reported outcomes after breast reconstruction: A preliminary propensity score-matched analysis Journal Article
| Authors: | Coriddi, M.; Kim, L. N.; Haglich, K.; McGrath, L.; Monge, J. J. L.; Shamsunder, M. G.; Mehrara, B. J.; Dayan, J. H.; Nelson, J. A. |
| Article Title: | The impact of lymphedema on patient-reported outcomes after breast reconstruction: A preliminary propensity score-matched analysis |
| Abstract: | Background: Studies on the impact of secondary lymphedema on patient-reported satisfaction and quality of life following postmastectomy breast reconstruction are limited by their heterogeneity. We aimed to reduce heterogeneity in study sample populations and compare BREAST-Q Reconstruction Module scores of patients with lymphedema matched to patients without lymphedema. Methods: We identified patients who underwent postmastectomy breast reconstruction from 2009 to 2017 and performed a propensity score-matched analysis to compare patient-reported outcomes of patients who developed lymphedema with those who did not. Matched covariates included age, body mass index, race/ethnicity, smoking history, radiation or chemotherapy exposure, postoperative infection, and reconstruction modality and laterality. Outcomes of interest were pre- and postoperative BREAST-Q scores for Satisfaction with Breasts, Physical Well-being of the Chest, Sexual Well-Being, and Psychosocial Well-Being; the minimal clinically important difference (MCID) was four points. Results: Matched cohorts included 322 patients per group. Preoperative BREAST-Q scores did not differ between lymphedema and non-lymphedema matched cohorts. Postoperative BREAST-Q scores were significantly lower in lymphedema patients: Physical Well-Being of the Chest (all time points), Satisfaction with Breast (at 1 and 2 years), Sexual Well-Being (at 2 years), and Psychosocial Well-Being (at 2 and 3 years). All significant differences in average scores were greater than the MCID. Conclusions: Patients with breast cancer-related lymphedema reported significantly lower Physical Well-Being of the Chest, Satisfaction with Breasts, Sexual Well-Being, and Psychosocial Well-Being at various time points. Our findings may prove useful for patient counseling and justify the need for further research on the prevention and treatment of this devastating disease. © 2023, Society of Surgical Oncology. |
| Keywords: | adult; middle aged; patient satisfaction; major clinical study; quality of life; mastectomy; cohort analysis; psychology; breast neoplasms; breast reconstruction; mammaplasty; retrospective study; lymphedema; breast tumor; patient reported outcome measures; adverse event; patient-reported outcome; propensity score; breast-q; humans; human; male; female; article; physical well-being; breast cancer-related lymphedema; minimal clinically important difference; social well-being; sexual well-being |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 30 |
| Issue: | 5 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2023-05-01 |
| Start Page: | 3061 |
| End Page: | 3071 |
| Language: | English |
| DOI: | 10.1245/s10434-022-12994-z |
| PUBMED: | 36641512 |
| PROVIDER: | scopus |
| PMCID: | PMC11071662 |
| DOI/URL: | |
| Notes: | Article -- MSK Cancer Center Support Grant (P30 CA008748) acknowledged in PubMed and PDF -- MSK corresponding authors are Michelle Coriddi and Jonas Nelson -- Export Date: 1 May 2023 -- Source: Scopus |
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