Impact of mastectomy flap necrosis on patient-reported quality-of-life measures after nipple-sparing mastectomy: A preliminary analysis Journal Article
| Authors: | Jones, V. M.; Nelson, J. A.; Sevilimedu, V.; Le, T.; Allen, R. J. Jr; Mehrara, B. J.; Barrio, A. V.; Capko, D. M.; Heerdt, A. S.; Tadros, A. B.; Gemignani, M. L.; Morrow, M.; Sacchini, V.; Moo, T. A. |
| Article Title: | Impact of mastectomy flap necrosis on patient-reported quality-of-life measures after nipple-sparing mastectomy: A preliminary analysis |
| Abstract: | Background: Mastectomy skin flap necrosis (SFN) is common following nipple-sparing mastectomy (NSM), but studies on its quality-of-life (QOL) impact are limited. We examined patient-reported QOL and satisfaction after NSM with/without SFN utilizing the BREAST-Q patient-reported outcome measure (PROM) survey. Patients and Methods: Patients undergoing NSM between April 2018 and July 2021 at our institution were examined; the BREAST-Q PROM was administered preoperatively, and at 6 months and 1 year postoperatively. SFN extent/severity was documented at 2–3 weeks postoperatively; QOL and satisfaction domains were compared between patients with/without SFN. Results: A total of 573 NSMs in 333 patients were included, and 135 breasts in 82 patients developed SFN (24% superficial, 56% partial thickness, 16% full thickness). Patients with SFN reported significantly lower scores in the satisfaction with breasts (p = 0.032) and psychosocial QOL domains (p = 0.009) at 6 months versus those without SFN, with scores returning to baseline at 1 year in both domains. In the “physical well-being-of-the-chest” domain, there was an overall decline in scores among all patients; however, there were no significant differences at any time point between patients with or without SFN. Sexual well-being scores declined for patients with SFN compared with those without at 6 months and also at 1 year, but this did not reach significance (p = 0.13, p = 0.2, respectively). Conclusions: Patients undergoing NSM who developed SFN reported significantly lower satisfaction and psychosocial well-being scores at 6 months, which returned to baseline by 1 year. Physical well-being of the chest significantly declines after NSM regardless of SFN. Future studies with larger sample sizes and longer follow-up are needed to determine SFN’s impact on long-term QOL. © Society of Surgical Oncology 2024. |
| Keywords: | adult; controlled study; aged; middle aged; patient satisfaction; major clinical study; postoperative period; surgical flaps; follow up; follow-up studies; antineoplastic agent; preoperative evaluation; treatment indication; cancer prevention; quality of life; breast cancer; mastectomy; cohort analysis; psychology; pathology; breast neoplasms; breast reconstruction; mammaplasty; graft necrosis; necrosis; postoperative complication; postoperative complications; conservative treatment; adjuvant chemotherapy; breast tumor; breast carcinoma; surgery; hormonal therapy; nipple; nipples; neoadjuvant chemotherapy; patient reported outcome measures; adjuvant radiotherapy; nipple-sparing mastectomy; breast surgery; etiology; adverse event; prophylactic mastectomy; patient-reported outcome measures; patient-reported outcome; procedures; invasive ductal carcinoma; breast-q; organ sparing treatments; humans; prognosis; human; female; article; physical well-being; breast radiotherapy; social well-being; ductal breast carcinoma in situ; invasive lobular breast carcinoma; sexual well-being; breast satisfaction; skin flap necrosis; autologous flap reconstruction; breast ptosis; patient history of mastectomy |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 31 |
| Issue: | 10 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2024-10-01 |
| Start Page: | 6795 |
| End Page: | 6803 |
| Language: | English |
| DOI: | 10.1245/s10434-024-15681-3 |
| PUBMED: | 38990221 |
| PROVIDER: | scopus |
| PMCID: | PMC11684468 |
| DOI/URL: | |
| Notes: | The MSK Cancer Center Support Grant (P30 CA008748) is acknowledge in the PDF -- Corresponding authors is MSK author: Tracy‑Ann Moo -- Source: Scopus |
