A C M van Bommel1, K M de Ligt2, K Schreuder2, J H Maduro3, T Van Dalen4, M T F D Vrancken Peeters5, M A M Mureau6, S Siesling2. 1. Department of Surgery, Albinusdreef 2, 2333 ZA, Leiden University Medical Centre, Leiden, the Netherlands; Dutch Institute for Clinical Auditing, Rijnsburgerweg 10, 2333 AA, Leiden, the Netherlands. Electronic address: a.c.m.van_bommel@lumc.nl. 2. Department of Research and Development, Netherlands Comprehensive Cancer Organisation (IKNL), Godebaldkwartier 419, 3511 DT, Utrecht, the Netherlands; Department of Health Technology and Services Research, Technical Medical Centre, University of Twente, PO Box 215, 7500 AE, Enschede, the Netherlands. 3. Department of Radiation Oncology, University of Groningen, University Medical Centre Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands. 4. Department of Surgery, Diakonessenhuis Utrecht, Bosboomstraat 1, 3582 KE, Utrecht, the Netherlands. 5. Department of Surgery, Netherlands Cancer Institute / Antoni van Leeuwenhoek, Plesmanlaan 121, 1066 CX, Amsterdam, the Netherlands. 6. Department of Plastic and Reconstructive Surgery, Erasmus MC Cancer Institute, University Medical Centre Rotterdam, Rotterdam, the Netherlands.
Abstract
BACKGROUND: Postmastectomy immediate breast reconstruction (IBR) may improve the quality of life (QoL) of breast cancer patients. Guidelines recommend to discuss the option IBR with all patients undergoing mastectomy. However, substantial hospital variation in IBR-rates was previously observed in the Netherlands, influenced by patient, tumour and hospital factors and clinicians' believes. Information provision about IBR may have a positive effect on receiving IBR and therefore QoL. This study investigated patient-reported QoL of patients treated with mastectomy with and without IBR. METHODS: An online survey, encompassing the validated BREAST-Q questionnaire, was distributed to a representative sample of 1218 breast cancer patients treated with mastectomy. BREAST-Q scores were compared between patients who had undergone mastectomy either with or without IBR. RESULTS: A total of 445 patients were included for analyses: 281 patients with and 164 without IBR. Patients who had received IBR showed significantly higher BREAST-Q scores on "psychosocial well-being" (75 versus 67, p < 0.001), "sexual well-being" (62 versus 52, p < 0.001) and "physical well-being" (77 versus 74, p = 0.021) compared to patients without IBR. No statistically significant difference was found for "satisfaction with breasts" (64 versus 62, p = 0.21). Similar results were found after multivariate regression analyses, revealing IBR to be an independent factor for a better patient-reported QoL. CONCLUSIONS: Patients diagnosed with breast cancer with IBR following mastectomy report a better QoL on important psychosocial, sexual and physical well-being domains. This further supports the recommendation to discuss the option of IBR with all patients with an indication for mastectomy and to enable shared decision-making.
BACKGROUND: Postmastectomy immediate breast reconstruction (IBR) may improve the quality of life (QoL) of breast cancerpatients. Guidelines recommend to discuss the option IBR with all patients undergoing mastectomy. However, substantial hospital variation in IBR-rates was previously observed in the Netherlands, influenced by patient, tumour and hospital factors and clinicians' believes. Information provision about IBR may have a positive effect on receiving IBR and therefore QoL. This study investigated patient-reported QoL of patients treated with mastectomy with and without IBR. METHODS: An online survey, encompassing the validated BREAST-Q questionnaire, was distributed to a representative sample of 1218 breast cancerpatients treated with mastectomy. BREAST-Q scores were compared between patients who had undergone mastectomy either with or without IBR. RESULTS: A total of 445 patients were included for analyses: 281 patients with and 164 without IBR. Patients who had received IBR showed significantly higher BREAST-Q scores on "psychosocial well-being" (75 versus 67, p < 0.001), "sexual well-being" (62 versus 52, p < 0.001) and "physical well-being" (77 versus 74, p = 0.021) compared to patients without IBR. No statistically significant difference was found for "satisfaction with breasts" (64 versus 62, p = 0.21). Similar results were found after multivariate regression analyses, revealing IBR to be an independent factor for a better patient-reported QoL. CONCLUSIONS:Patients diagnosed with breast cancer with IBR following mastectomy report a better QoL on important psychosocial, sexual and physical well-being domains. This further supports the recommendation to discuss the option of IBR with all patients with an indication for mastectomy and to enable shared decision-making.
Authors: Alison P Woods; Marianna V Papageorge; Susanna W L de Geus; Andrea Alonso; Andrea Merrill; Michael R Cassidy; Daniel S Roh; Teviah E Sachs; David McAneny; Frederick Thurston Drake Journal: Ann Surg Oncol Date: 2022-08-06 Impact factor: 4.339