Long-term patient-reported outcomes comparing oncoplastic breast surgery and conventional breast-conserving surgery: A propensity score-matched analysis Journal Article
| Authors: | Pak, L. M.; Matar-Ujvary, R.; Verdial, F. C.; Haglich, K. A.; Sevilimedu, V.; Nelson, J. A.; Gemignani, M. L. |
| Article Title: | Long-term patient-reported outcomes comparing oncoplastic breast surgery and conventional breast-conserving surgery: A propensity score-matched analysis |
| Abstract: | Introduction: Oncoplastic breast surgery (OBS) combines plastic surgery techniques with conventional breast-conserving surgery (BCS) and expands BCS eligibility. Limited data are available on patient-reported outcomes (PROs) after OBS. Here we compare long-term PROs after OBS and BCS utilizing the BREAST-Q. Patients and Methods: Women undergoing OBS or BCS between 2006 and 2019 who completed ≥ 1 long-term BREAST-Q survey 3–5 years postoperatively were identified. Baseline characteristics were compared between women who underwent OBS/BCS. Women who underwent OBS were paired with those who underwent BCS using 1:2 propensity matching [by age, body mass index (BMI), race, T stage, and multifocality]. BREAST-Q scores were compared preoperatively and 3–5 years postoperatively. Results: A total of 297 patients were included for analysis (99 OBS/198 BCS). Women who underwent OBS were younger (p < 0.001) and had higher BMI (p = 0.005) and multifocal disease incidence (p = 0.004). There was no difference between groups in nodal stage, re-excision rates, axillary surgery, chemotherapy, endocrine therapy, or radiotherapy. After propensity matching preoperatively, women who underwent OBS reported lower psychosocial well-being (63 versus 100, p = 0.039) but similar breast satisfaction and sexual well-being compared with women who underwent BCS; however, only three patients who underwent BCS had preoperative BREAST-Q scores available for review. In long-term follow-up, women who underwent OBS reported lower psychosocial scores (74 versus 93, p = 0.011) 4 years postoperatively, but not at 5 years (76 versus 77, p = 0.83). There was no difference in long-term breast satisfaction or sexual well-being. Conclusions: Women who undergo OBS present with a larger disease burden and may represent a group of non-traditional BCS candidates; they reported similar long-term breast satisfaction and sexual well-being compared with women who undergo BCS. While women who underwent OBS reported lower psychosocial well-being scores preoperatively and during a portion of the follow-up period, this difference was no longer seen at 5 years postoperatively. © 2023, Society of Surgical Oncology. |
| Keywords: | adult; cancer chemotherapy; patient satisfaction; cancer surgery; retrospective studies; major clinical study; cancer radiotherapy; cancer staging; follow up; antineoplastic agent; preoperative evaluation; breast cancer; mastectomy; tumor volume; morbidity; breast neoplasms; breast reconstruction; mammaplasty; retrospective study; cancer hormone therapy; body mass; breast tumor; partial mastectomy; patient reported outcome measures; breast surgery; mastectomy, segmental; race; patient-reported outcome measures; breast-conserving surgery; patient-reported outcome; procedures; propensity score; breast-q; humans; human; female; article; oncoplastic breast surgery; social well-being; propensity matching; sexual well-being |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 30 |
| Issue: | 12 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2023-11-01 |
| Start Page: | 7091 |
| End Page: | 7098 |
| Language: | English |
| DOI: | 10.1245/s10434-023-13962-x |
| PUBMED: | 37556008 |
| PROVIDER: | scopus |
| PMCID: | PMC10996134 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in PubMed and PDF -- Corresponding author is MSK author: Mary L. Gemignani -- Source: Scopus |
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