Division of Plastic Surgery, Universidade Federal de São Paulo, São Paulo, Brazil.
Plast Reconstr Surg. 2010 Mar;125(3):811-7. doi: 10.1097/PRS.0b013e3181ccdac5.
This prospective trial was designed to assess the impact of oncoplastic surgery on quality of life and self-esteem of breast cancer patients undergoing breast-conserving treatment.
Forty-five patients with primary breast cancer to be treated with breast-conserving surgery and immediate partial breast reconstruction were assessed with regard to quality-of-life and self-esteem outcomes preoperatively and 6 and 12 months postoperatively. Another 42 breast cancer patients, treated by conservative surgery without breast reconstruction at least 1 year previously, were assessed for the control group. Validated questionnaires (Short Form-36, Brazilian version, and the Rosenberg-EPM Self-Esteem Scale) were used. Data were analyzed by using the Mann-Whitney and Friedman tests.
Participation rates at the follow-up assessments were 95.5 percent at the 6-month follow-up and 88.9 percent at the 12-month follow-up. Control and reconstruction groups were matched for age, body mass index, and demographic and oncologic aspects. At postoperative month 12, the breast reconstruction group had significantly better health status than the control group with regard to physical functioning (p < 0.000), health perception (p < 0.002), vitality (p < 0.007), social functioning (p < 0.02), role emotional (p < 0.02), mental health (p < 0.000), and self-esteem (p < 0.02). Compared with preoperatively, breast reconstruction group scores were significantly higher at 12 months postoperatively for seven of the eight dimensions of the Short Form-36: physical functioning (p < 0.01), role physical (p < 0.02), health perception (p < 0.02), vitality (p < 0.01), social functioning (p < 0.02), role emotional (p < 0.05), and mental health (p < 0.02). Self-esteem was also significantly better at 12 months (p < 0.02).
Oncoplastic surgery had a positive impact on quality of life and self-esteem of patients undergoing breast-conserving treatment.
本前瞻性试验旨在评估保乳治疗的乳腺癌患者接受整形手术对生活质量和自尊的影响。
对 45 例原发性乳腺癌患者进行评估，这些患者将接受保乳手术和即刻部分乳房重建，评估术前、术后 6 个月和 12 个月的生活质量和自尊结果。另外 42 例接受过至少 1 年保乳手术但未行乳房重建的乳腺癌患者作为对照组进行评估。使用了经过验证的问卷（36 项简短健康调查问卷，巴西版和罗森伯格自尊量表）。采用 Mann-Whitney 和 Friedman 检验进行数据分析。
6 个月和 12 个月的随访评估中，参与率分别为 95.5%和 88.9%。对照组和重建组在年龄、体重指数以及人口统计学和肿瘤学方面相匹配。在术后 12 个月时，重建组在身体功能（p<0.000）、健康感知（p<0.002）、活力（p<0.007）、社会功能（p<0.02）、情感角色（p<0.02）、心理健康（p<0.000）和自尊（p<0.02）方面的健康状况明显优于对照组。与术前相比，重建组在术后 12 个月时 8 个 36 项简短健康调查问卷维度中的 7 个维度的评分显著升高：身体功能（p<0.01）、身体角色（p<0.02）、健康感知（p<0.02）、活力（p<0.01）、社会功能（p<0.02）、情感角色（p<0.05）和心理健康（p<0.02）。自尊在 12 个月时也显著改善（p<0.02）。
整形手术对接受保乳治疗的乳腺癌患者的生活质量和自尊产生了积极影响。
