Michael J Stein1, Aneesh Karir2, Angel Arnaout3, Amanda Roberts3, Erin Cordeiro3, Tinghua Zhang4, Jing Zhang5. 1. Division of Plastic and Reconstructive Surgery, University of Ottawa, Ottawa, ON, Canada. 2. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada. 3. Division of General Surgery, University of Ottawa, Ottawa, ON, Canada. 4. The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada. 5. Division of Plastic and Reconstructive Surgery, University of Ottawa, Ottawa, ON, Canada. jzhang@toh.ca.
Abstract
BACKGROUND: Therapeutic reduction mammoplasty (TRM) is a safe and effective surgical technique that has oncologic outcomes comparable with those achieved by mastectomy. This study aimed to compare surgical and patient-reported outcomes between breast cancer patients treated with TRM and those who had mastectomy with immediate reconstruction (MIR). METHODS: A 4-year, single-institution, retrospective cohort study analyzed breast cancer patients undergoing TRM and MIR. Patient characteristics and perioperative data were collected from electronic records. Patient-reported outcome data were collected via BREAST-Q questionnaires preoperatively, then 3 months and 12 months postoperatively. A subgroup analysis was performed on locally advanced breast cancer (LABC) patients for TRM and MIR. RESULTS: The study included 249 breast reconstructions, of which 77 (31%) were TRM and 172 (69%) were MIR. The mean follow-up time was 2.4 ± 1.2 years. Compared with MIR, TRM had significantly lower major complication rates (9% vs 21%; p = 0.02) and fewer revisionary surgeries (5% vs 37%; p < 0.0001). At 1 year postoperatively, TRM had a significantly greater change in satisfaction with breasts, (+ 27.7 vs + 4.6; p < 0.01) and sexual well-being (+ 20.0 vs - 5.5; p = 0.02) than MIR. CONCLUSION: For select breast cancer patients, TRM continues to be a safe and effective alternative to mastectomy. The current study demonstrated that TRM patients had fewer major complications and revisionary surgeries, as well as better patient-reported outcomes than MIR.
BACKGROUND: Therapeutic reduction mammoplasty (TRM) is a safe and effective surgical technique that has oncologic outcomes comparable with those achieved by mastectomy. This study aimed to compare surgical and patient-reported outcomes between breast cancerpatients treated with TRM and those who had mastectomy with immediate reconstruction (MIR). METHODS: A 4-year, single-institution, retrospective cohort study analyzed breast cancerpatients undergoing TRM and MIR. Patient characteristics and perioperative data were collected from electronic records. Patient-reported outcome data were collected via BREAST-Q questionnaires preoperatively, then 3 months and 12 months postoperatively. A subgroup analysis was performed on locally advanced breast cancer (LABC) patients for TRM and MIR. RESULTS: The study included 249 breast reconstructions, of which 77 (31%) were TRM and 172 (69%) were MIR. The mean follow-up time was 2.4 ± 1.2 years. Compared with MIR, TRM had significantly lower major complication rates (9% vs 21%; p = 0.02) and fewer revisionary surgeries (5% vs 37%; p < 0.0001). At 1 year postoperatively, TRM had a significantly greater change in satisfaction with breasts, (+ 27.7 vs + 4.6; p < 0.01) and sexual well-being (+ 20.0 vs - 5.5; p = 0.02) than MIR. CONCLUSION: For select breast cancerpatients, TRM continues to be a safe and effective alternative to mastectomy. The current study demonstrated that TRMpatients had fewer major complications and revisionary surgeries, as well as better patient-reported outcomes than MIR.
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