Sinno Hani, Izadpanah Ali, Vorstenbosch Joshua, Dionisopoulos Tassos, Ibrahim Ahmed M S, Tobias Adam M, Lee Bernard T, Lin Samuel J
Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
Division of Plastic Surgery, McGill University, Montreal, Quebec, Canada.
J Reconstr Microsurg. 2014 Jun;30(5):313-8. doi: 10.1055/s-0033-1361842. Epub 2014 Feb 17.
The gold standard for the treatment of breast cancer includes mastectomy surgery. Our goal was to quantify the health state utility assessment of living with unilateral mastectomy.
The visual analogue scale (VAS), time trade-off (TTO), and standard gamble (SG) were used to obtain utilities for unilateral mastectomy, monocular blindness and binocular blindness from a prospective sample of the general population and medical students.
All measures (VAS, TTO, SG) for unilateral mastectomy (0.75 SD 0.17, 0.87 SD 0.14, and 0.86 SD 0.18, respectively) of the 140 volunteers were significantly different from the corresponding scores for monocular (0.61 SD 0.18, 0.84 SD 0.17, and 0.84 SD 0.18, respectively) and binocular blindness (0.38 SD 0.17, 0.67 SD 0.24, and 0.69 SD 0.23, respectively). Age, gender, race, education, and income were not statistically significant independent predictors of utility scores.
In a sample of the general population and medical students, utility assessments for living with unilateral mastectomy were comparable with those of living with bilateral mastectomy and severe breast hypertrophy. Our sample population, if faced living with unilateral mastectomy was willing to gamble a theoretical 14% chance of death and willing to trade 4.2 years of existing life-years.
乳腺癌治疗的金标准包括乳房切除术。我们的目标是量化单侧乳房切除术后生活的健康状态效用评估。
使用视觉模拟量表（VAS）、时间权衡法（TTO）和标准博弈法（SG），从前瞻性选取的普通人群和医学生样本中获取单侧乳房切除术、单眼失明和双眼失明的效用值。
140名志愿者的单侧乳房切除术的所有测量指标（VAS、TTO、SG）（分别为0.75±0.17、0.87±0.14和0.86±0.18）与单眼失明（分别为0.61±0.18、0.84±0.17和0.84±0.18）和双眼失明（分别为0.38±0.17、0.67±0.24和0.69±0.23）的相应分数有显著差异。年龄、性别、种族、教育程度和收入不是效用分数的统计学显著独立预测因素。
在普通人群和医学生样本中，单侧乳房切除术后生活的效用评估与双侧乳房切除术和严重乳房肥大术后生活的效用评估相当。我们的样本人群如果面临单侧乳房切除术，愿意冒着理论上14%的死亡风险，并且愿意用4.2年的现有寿命进行交换。
