Patient-reported outcomes in patients undergoing lumpectomy with and without defect closure Journal Article
| Authors: | Palmquist, E.; Sevilimedu, V.; Garcia, P.; Le, T.; Zhang, X.; Pinker-Domenig, K.; Hanna, M. G.; Nelson, J. A.; Morrow, M.; El-Tamer, M. |
| Article Title: | Patient-reported outcomes in patients undergoing lumpectomy with and without defect closure |
| Abstract: | Background: The effect of lumpectomy defect repair (a level 1 oncoplastic technique) on patient-reported breast satisfaction among patients undergoing lumpectomy has not yet been investigated. Methods: Patients undergoing lumpectomy at our institution between 2018 and 2020 with or without repair of their lumpectomy defect during index operation, comprised our study population. The BREAST-Q quality-of-life questionnaire was administered preoperatively, and at 6 months, 1 year, and 2 years postoperatively. Satisfaction and quality-of-life domains were compared between those who did and did not have closure of their lumpectomy defect, and compared with surgeon-reported outcomes. Results: A total of 487 patients met eligibility criteria, 206 (42%) had their partial mastectomy defect repaired by glandular displacement. Median breast volume, as calculated from the mammogram, was smaller in patients undergoing defect closure (826 cm3 vs. 895 cm3, p = 0.006). There were no statistically significant differences in satisfaction with breasts (SABTR), physical well-being of the chest (PWB-CHEST), or psychosocial well-being (PsychWB) scores between the two cohorts at any time point. While patients undergoing defect closure had significantly higher sexual well-being (SexWB) scores compared with no closure (66 vs. 59, p = 0.021), there were no predictors of improvement in SexWB scores over time on multivariable analysis. Patients’ self-reported scores positively correlated with physician-reported outcomes. Conclusions: Despite a larger lumpectomy-to-breast volume ratio among patients undergoing defect repair, satisfaction was equivalent among those whose defects were or were not repaired at 2 years postsurgery. Defect repair was associated with clinically relevant improvement in patient-reported sexual well-being. © Society of Surgical Oncology 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
| Keywords: | adult; controlled study; aged; patient satisfaction; cancer surgery; major clinical study; clinical feature; cancer radiotherapy; comparative study; cancer staging; antineoplastic agent; quality of life; breast cancer; breast; mastectomy; cohort analysis; health survey; breast neoplasms; breast reconstruction; mammaplasty; postoperative complication; population research; mammography; breast tumor; partial mastectomy; invasive carcinoma; neoadjuvant chemotherapy; patient-reported outcomes; patient reported outcome measures; mastectomy, segmental; lumpectomy; clinical outcome; demographics; patient-reported outcome; procedures; estrogen receptor positive breast cancer; human epidermal growth factor receptor 2 positive breast cancer; breast-q; humans; human; female; article; progesterone receptor positive breast cancer; physical well-being; benign breast tumor; breast radiotherapy; social well-being; ductal breast carcinoma in situ; sexual well-being; breast satisfaction; mskcc score |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 31 |
| Issue: | 3 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2024-03-01 |
| Start Page: | 1615 |
| End Page: | 1622 |
| Language: | English |
| DOI: | 10.1245/s10434-023-14584-z |
| PUBMED: | 38063989 |
| PROVIDER: | scopus |
| PMCID: | PMC10923194 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PDF -- Corresponding author is MSK authors: Mahmoud El‑Tamer -- Source: Scopus |
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