American Association of Plastic Surgeons

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Prospective Evaluation Of Quality Of Life Outcomes For Patients With Early Breast Cancer Treated With Breast Conserving Surgery, Mastectomy Alone And Mastectomy With Immediate Breast Reconstruction
Helene Retrouvey, MDCM, Toni Zhong, MD, MHS, FRCS(C).
University of Toronto, Toronto, ON, Canada.

PURPOSE: To evaluate the change in satisfaction and quality of life between early breast cancer patients treated with breast conserving surgery (BCT), mastectomy alone (MA) or mastectomy with immediate breast reconstruction (IBR) at one year after surgery using the BREAST-Q.
METHODS: All early stage breast cancer patients treated between 2015 and 2017 were compared using the BREAST-Q breast satisfaction (BS) and psychosocial well being (PSW) scales. A multivariate linear regression was performed to assess changes in BS and PSW scores between baseline and 12 months. Clinically relevant factors were included (age, income, education, ethnicity, cancer stage and laterality).
RESULTS: A total of 242 patients were prospectively enrolled; 107 underwent BCT, 56 MA and 79 IBR. The three groups had similar baseline BS and PSW scores. At 12 months, BCT had the highest scores, followed by IBR, then MA (p<0.0001). After multivariate regression, IBR was not statistically different than BCT. MA patients experienced lower satisfaction and wellbeing compared to BCT (p<0.0001). IBR led to higher wellbeing than MA (p=0.0039).
CONCLUSION: This large prospective study highlights that changes in satisfaction and wellbeing at 12 months for BCT and IBR are no different in early stage breast cancer patients, but are significantly reduced in MA. This study is the first to compare BREAST-Q outcomes between BCT, MA and IBR, and provides important evidence to support the use of BCT or IBR to optimize long-term quality of life for early stage breast cancer patients.


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