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Comparative Study
. 2019 Oct;26(10):3133-3140.
doi: 10.1245/s10434-019-07548-9. Epub 2019 Jul 24.

A Comparison of Patient-Reported Outcomes After Breast-Conserving Surgery and Mastectomy with Implant Breast Reconstruction

Meghan R Flanagan  1 , Emily C Zabor  2 , Anya Romanoff  1 , Sarah Fuzesi  1 , Michelle Stempel  1 , Babak J Mehrara  3 , Monica Morrow  1 , Andrea L Pusic  4 , Mary L Gemignani  5
Affiliations
Comparative Study

A Comparison of Patient-Reported Outcomes After Breast-Conserving Surgery and Mastectomy with Implant Breast Reconstruction

Meghan R Flanagan et al. Ann Surg Oncol. 2019 Oct.

Abstract

Background: Many factors influence decisions regarding choice of breast-conserving surgery (BCS) versus mastectomy with reconstruction for early invasive breast cancer. The purpose of this study was to compare patient satisfaction following BCS and mastectomy with implant reconstruction (M-iR) utilizing the BREAST-Q patient-reported outcome measure.

Methods: Women with stage I or II breast cancer undergoing BCS or M-iR who completed a BREAST-Q from 2010 to 2016 were identified by retrospective review of a prospective database. Baseline characteristics were compared, and linear mixed models were used to analyze associations with BREAST-Q scores over time.

Results: Our study group was composed of 3233 women; 2026 (63%) had BCS, 123 (3.8%) had nipple-sparing mastectomy, and 1084 (34%) had skin-sparing or total mastectomy. Median time from surgery to BREAST-Q was 205 days for BCS and 639 days for M-iR (p < 0.001). Regardless of type of surgery, breast satisfaction scores decreased significantly over time (p < 0.001), whereas psychosocial (p = 0.001) and sexual (p = 0.004) well-being scores increased significantly over time. BCS was associated with significantly higher scores over time compared with M-iR across all subscales (all p < 0.001). Radiation was significantly associated with decreased scores over time across all subscales (all p < 0.05).

Conclusions: Breast satisfaction and quality-of-life scores were higher for BCS compared with M-iR in early-stage invasive breast cancer. These findings may help in counseling women who have a choice for surgical treatment. Breast satisfaction scores decreased over time in all women, highlighting the need for further evaluation with longer follow-up.

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Figures

Fig 1.
Fig 1.
Distribution of time from surgery to BREASTQ measurement in BCS compared to M-iR separately for each subscale and according to surgery type. BCS breast-conserving surgery, M-iR mastectomy with implant reconstruction
Fig. 2.
Fig. 2.
Association between time from surgery and BREAST-Q score, separately for each subscale and according to surgery type. BCS breast-conserving surgery, M-iR mastectomy with implant reconstruction
See this image and copyright information in PMC

References

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