Antonio J Esgueva1, Iris Noordhoek2, Elma Meershoek-Klein Kranenbarg2, Martin Espinosa-Bravo3, Zoltán Mátrai4, Andrii Zhygulin5, Arvids Irmejs6, Carlos Mavioso7, Francesco Meani8, Eduardo González9, Murat Özdemir10, Tanir Allweis11, Karol Rogowski12, Catarina Rodrigues Dos Santos13, Henrique Mora14, Riccardo Ponzone15, Domenico Samorani16, Cornelis van de Velde2, Riccardo A Audisio17, Isabel T Rubio18. 1. Breast Surgical Oncology Unit, Clinica Universidad de Navarra, Cancer Center Universidad de Navarra, Madrid, Spain. 2. Leiden University Medical Center, Leiden, The Netherlands. 3. Breast Surgical Unit, Hospital Universitario Vall d'Hebron, Barcelona, Spain. 4. Department of Breast and Sarcoma Surgery, National Institute of Oncology, Budapest, Hungary. 5. Breast Unit, LISOD, Hospital of Israeli Oncology, Kiev, Ukraine. 6. Breast Unit, Pauls Stradins Clinical University Hospital, Institute of Oncology, Riga Stradins University, Riga, Latvia. 7. Breast Unit Centro Clínico Champalimaud, Lisboa, Portugal. 8. Centro di Senologia della Svizzera Italiana, Ente Ospedaliero Cantonale, Bellinzona, Switzerland. 9. Instituto de Oncología Ángel H. Roffo, Buenos Aires, Argentina. 10. Ege Üniversitesi, Izmir, Turkey. 11. Kaplan Medical Center, Rehovot, Israel. 12. Bialostockie Centrum Onkologii, Bialystok, Poland. 13. IPO Francisco Gentil, Lisboa, Portugal. 14. Centro Hospitalar Universitário Sao Joao, Porto, Portugal. 15. Candiolo Cancer Institute, FPO - IRCCS, Turin, Italy. 16. AUSL Romagna, Rimini, Italy. 17. Sahlgrenska Universitetssjukhuset, Gotenburg, Sweden. 18. Breast Surgical Oncology Unit, Clinica Universidad de Navarra, Cancer Center Universidad de Navarra, Madrid, Spain. irubior@unav.es.
Abstract
INTRODUCTION: Nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) is increasingly used for both breast cancer (TNSM) and risk reduction (RRNSM). The aim of the study is to report the results of the INSPIRE registry assessing health-related quality of life (HRQoL) comparing baseline and 1-year follow-up, regarding surgical indications and chemotherapy (CT) received. METHODS: INSPIRE is a prospective database including women undergoing NSM and IBR from 18 countries. HRQoL was measured using EORTC QLQC30 and QLQ-BR23 before surgery and after 1 year. RESULTS: A total of 677 women were included, of whom 537 (79.3%) underwent TNSM and 140 (21.6%) RRNSM: in total, 806 NSM (556 TNSM and 250 RRNSM). Nipple involvement was present in 7.73% of TNSM and incidental carcinoma in 1.2% of the RRNSM group. Out of the overall 537 patients with systemic treatment, 177 (32.96%) received neoadjuvant chemotherapy (NCT) and 118 (21.92%) adjuvant chemotherapy (CT). A total of 227 patients (28.16%) developed at least one complication postoperatively, 164 (29.5%) in the TNSM group and 63 (25.2%) in the RRNSM group. The TNSM group improved in global health status and emotional functioning after 1 year. No differences were found when comparing HRQoL at 1 year between patients who received NCT and those who received adjuvant CT. The RRNSM group showed improvement in HRQoL, with better emotional functioning and fatigue after 1 year. CONCLUSIONS: This registry reports HRQoL findings after NSM. The impact of CT on worse HRQoL is independent from its timing. Patients with RRNSM showed an improved HRQoL at 1-year follow-up. Discussion of HRQoL outcomes with patients will facilitate the informed decision-making when considering NSM.
INTRODUCTION: Nipple-sparing mastectomy (NSM) with immediate breast reconstruction (IBR) is increasingly used for both breast cancer (TNSM) and risk reduction (RRNSM). The aim of the study is to report the results of the INSPIRE registry assessing health-related quality of life (HRQoL) comparing baseline and 1-year follow-up, regarding surgical indications and chemotherapy (CT) received. METHODS: INSPIRE is a prospective database including women undergoing NSM and IBR from 18 countries. HRQoL was measured using EORTC QLQC30 and QLQ-BR23 before surgery and after 1 year. RESULTS: A total of 677 women were included, of whom 537 (79.3%) underwent TNSM and 140 (21.6%) RRNSM: in total, 806 NSM (556 TNSM and 250 RRNSM). Nipple involvement was present in 7.73% of TNSM and incidental carcinoma in 1.2% of the RRNSM group. Out of the overall 537 patients with systemic treatment, 177 (32.96%) received neoadjuvant chemotherapy (NCT) and 118 (21.92%) adjuvant chemotherapy (CT). A total of 227 patients (28.16%) developed at least one complication postoperatively, 164 (29.5%) in the TNSM group and 63 (25.2%) in the RRNSM group. The TNSM group improved in global health status and emotional functioning after 1 year. No differences were found when comparing HRQoL at 1 year between patients who received NCT and those who received adjuvant CT. The RRNSM group showed improvement in HRQoL, with better emotional functioning and fatigue after 1 year. CONCLUSIONS: This registry reports HRQoL findings after NSM. The impact of CT on worse HRQoL is independent from its timing. Patients with RRNSM showed an improved HRQoL at 1-year follow-up. Discussion of HRQoL outcomes with patients will facilitate the informed decision-making when considering NSM.
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