Helene Retrouvey1, Isabel Kerrebijn2, Kelly A Metcalfe3, Anne C O'Neill1, David R McCready4, Stefan O P Hofer1, Toni Zhong5. 1. Division of Plastic and Reconstructive Surgery, Toronto General Hospital, Toronto, ON, Canada. 2. Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada. 3. Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Women's College Research Institute, Toronto, Canada. 4. Department of Surgical Oncology, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada. 5. Division of Plastic and Reconstructive Surgery, Toronto General Hospital, Toronto, ON, Canada. toni.zhong@uhn.on.ca.
Abstract
PURPOSE: To compare psychosocial function outcomes in early breast cancer patients treated with breast-conserving surgery (BCS), mastectomy alone (MA), and mastectomy with immediate breast reconstruction (IBR) at 1 year after surgery. METHODS: Early-stage (stage 0-2) breast cancer patients treated with BCS, MA, and IBR at the University Health Network, Toronto, Ontario, Canada between May 1 2015 and July 31 2016 were prospectively enrolled. Their changes in psychosocial functioning from baseline to 12 months following surgery were compared by using the BREAST-Q, Hospital Anxiety and Depression Scale, and Impact of Event Scale with ANOVA and linear regression. RESULTS: There were 303 early-stage breast cancer patients: 155 underwent BCS, 78 MA, and 70 IBR. After multivariable regression accounting for age, baseline score, income, education, receipt of chemoradiation or hormonal therapy, ethnicity, cancer stage, and unilateral versus bilateral surgery, breast satisfaction was highest in BCS (72.1, SD 19.6), followed by IBR (60.0, SD 18.0), and MA (49.9, SD 78.0) at 12 months, p < 0.001. Immediate breast reconstruction had similar psychosocial well-being (69.9, SD 20.6) compared with BCS (78.5, SD 20.6), p = 0.07. Sexual and chest physical well-being were similar between IBR, BCS, and MA, p > 0.05. CONCLUSIONS: Our study found that in a multidisciplinary breast cancer centre where all three breast ablative and reconstruction options are available to early breast cancer patients, either BCS or IBR can be used to provide patients with a higher degree of satisfaction and psychosocial well-being compared with MA in the long-term.
PURPOSE: To compare psychosocial function outcomes in early breast cancerpatients treated with breast-conserving surgery (BCS), mastectomy alone (MA), and mastectomy with immediate breast reconstruction (IBR) at 1 year after surgery. METHODS: Early-stage (stage 0-2) breast cancerpatients treated with BCS, MA, and IBR at the University Health Network, Toronto, Ontario, Canada between May 1 2015 and July 31 2016 were prospectively enrolled. Their changes in psychosocial functioning from baseline to 12 months following surgery were compared by using the BREAST-Q, Hospital Anxiety and Depression Scale, and Impact of Event Scale with ANOVA and linear regression. RESULTS: There were 303 early-stage breast cancerpatients: 155 underwent BCS, 78 MA, and 70 IBR. After multivariable regression accounting for age, baseline score, income, education, receipt of chemoradiation or hormonal therapy, ethnicity, cancer stage, and unilateral versus bilateral surgery, breast satisfaction was highest in BCS (72.1, SD 19.6), followed by IBR (60.0, SD 18.0), and MA (49.9, SD 78.0) at 12 months, p < 0.001. Immediate breast reconstruction had similar psychosocial well-being (69.9, SD 20.6) compared with BCS (78.5, SD 20.6), p = 0.07. Sexual and chest physical well-being were similar between IBR, BCS, and MA, p > 0.05. CONCLUSIONS: Our study found that in a multidisciplinary breast cancer centre where all three breast ablative and reconstruction options are available to early breast cancerpatients, either BCS or IBR can be used to provide patients with a higher degree of satisfaction and psychosocial well-being compared with MA in the long-term.
Authors: Catherine Pesce; Jennifer Jaffe; Kristine Kuchta; Katharine Yao; Mark Sisco Journal: Breast Cancer Res Treat Date: 2020-10-08 Impact factor: 4.872
Authors: Brett T Phillips; Genevieve Mercier-Couture; Amy S Xue; Carrie K Chu; Mark V Schaverien; Jun Liu; Patrick B Garvey; Donald P Baumann; Charles E Butler; Rene D Largo Journal: Plast Reconstr Surg Glob Open Date: 2020-11-24