Examining race and patient-reported outcomes after contralateral prophylactic mastectomy with reconstruction Journal Article
| Authors: | Myers, S. P.; Bayard, S.; Tadros, A. B.; Sevilimedu, V.; Matros, E.; Nelson, J. A.; Le, T.; Garcia, P.; Morrow, M.; Lee, M. K. |
| Article Title: | Examining race and patient-reported outcomes after contralateral prophylactic mastectomy with reconstruction |
| Abstract: | Background: Little is known regarding racial differences in satisfaction and quality of life (QOL) after contralateral prophylactic mastectomy (CPM). In this study, we aim to characterize associations between race, and postoperative satisfaction and well-being, utilizing the validated BREAST-Q patient-reported outcome measure. Patients and Methods: Patients were eligible if they were diagnosed with stage 0–III unilateral breast cancer and underwent mastectomy with immediate reconstruction at our institution between 2016 and 2022. BREAST-Q surveys were administered in routine clinical care preoperatively and postoperatively to assess QOL. We assessed whether the relationship between race, and domains of satisfaction with breasts and psychosocial well-being differed by receipt of CPM compared with unilateral mastectomy at 6 months, 1 year, 2 years, and 3 years following reconstruction. Results: Of 3334 women, 2040 (61%) underwent unilateral mastectomy and 1294 (39%) underwent CPM. Compared with White and Asian women who received CPM, Black women who underwent CPM were more likely to have higher BMI (p < 0.001), undergo autologous reconstruction (p = 0.006), and receive postmastectomy radiation (PMRT) (p < 0.001). There was no association between race and domains of satisfaction of breasts or psychosocial well-being for women who underwent unilateral mastectomy (p = 0.6 and p > 0.9, respectively) or CPM (p = 0.8 and p = 0.9, respectively). PMRT was negatively associated with both satisfaction with breasts (p < 0.001) and psychosocial well-being (p = 0.007). Conclusions: Differences in satisfaction with breasts and psychosocial well-being at 3-year follow-up were not associated with race but rather treatment variables, particularly the receipt of PMRT. Further investigations with a larger and more diverse population are needed to validate these findings. © 2023, Society of Surgical Oncology. |
| Keywords: | adult; controlled study; middle aged; patient satisfaction; major clinical study; adjuvant therapy; cancer patient; cancer radiotherapy; postoperative care; cancer staging; follow up; antineoplastic agent; quality of life; breast cancer; mastectomy; psychology; breast neoplasms; breast reconstruction; mammaplasty; cancer hormone therapy; depression; body mass; adjuvant chemotherapy; breast tumor; anxiety; patient reported outcome measures; free tissue graft; antineoplastic hormone agonists and antagonists; caucasian; longitudinal study; race; hispanic; medical history; asian; prophylactic mastectomy; contralateral prophylactic mastectomy; patient-reported outcome; non-smoker; breast-q; humans; human; female; article; black person; married person; breast carcinoma in situ; current smoker; ex-smoker; social well-being; anatomical location |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 31 |
| Issue: | 2 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2024-02-01 |
| Start Page: | 966 |
| End Page: | 973 |
| Language: | English |
| DOI: | 10.1245/s10434-023-14527-8 |
| PUBMED: | 37973646 |
| PROVIDER: | scopus |
| PMCID: | PMC11110644 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK author: Minna K. Lee -- Source: Scopus |
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