Ibrahim Ahmed M S, Sinno Hani H, Izadpanah Ali, Vorstenbosch Joshua, Dionisopoulos Tassos, Mureau Marc A M, Tobias Adam M, Lee Bernard T, Lin Samuel J
Division of Plastic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Mass.; Division of Plastic and Reconstructive Surgery, McGill University Health Center, McGill University, Montreal, Quebec, Canada; and Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
Plast Reconstr Surg Glob Open. 2015 May 7;3(4):e380. doi: 10.1097/GOX.0000000000000133. eCollection 2015 Apr.
Nipple-areola complex (NAC) reconstruction occurs toward the final stage of breast reconstruction; however, not all women follow through with these procedures. The goal of this study was to determine the impact of the health state burden of living with a reconstructed breast before NAC reconstruction.
A sample of the population and medical students at McGill University were recruited to establish the utility scores [visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG)] of living with an NAC deformity. Utility scores for monocular and binocular blindness were determined for validation and comparison. Linear regression and Student's t test were used for statistical analysis, and significance was set at P < 0.05.
There were 103 prospective volunteers included. Utility scores (VAS, TTO, and SG) for NAC deformity were 0.84 ± 0.18, 0.92 ± 0.11, and 0.92 ± 0.11, respectively. Age, gender, and ethnicity were not statistically significant independent predictors of utility scores. Income thresholds of <$10,000 and >$10,000 revealed a statistically significant difference for VAS (P = 0.049) and SG (P = 0.015). Linear regression analysis showed that medical education was directly proportional to the SG and TTO scores (P < 0.05).
The absence of NAC in a reconstructed breast can be objectively assessed using utility scores (VAS, 0.84 ± 0.18; TTO, 0.92 ± 0.11; SG, 0.92 ± 0.11). In comparison to prior reported conditions, the quality of life in patients choosing to undergo NAC reconstruction is similar to that of persons living with a nasal deformity or an aging neck requiring rejuvenation.
乳头乳晕复合体（NAC）重建是乳房重建的最后阶段；然而，并非所有女性都会完成这些手术。本研究的目的是确定在进行NAC重建之前，乳房重建患者的健康状态负担所产生的影响。
招募了麦吉尔大学的部分人群和医学生，以确定NAC畸形患者的效用评分[视觉模拟量表（VAS）、时间权衡法（TTO）和标准博弈法（SG）]。确定单眼和双眼失明的效用评分以进行验证和比较。采用线性回归和学生t检验进行统计分析，显著性设定为P < 0.05。
共有103名前瞻性志愿者参与。NAC畸形的效用评分（VAS、TTO和SG）分别为0.84±0.18、0.92±0.11和0.92±0.11。年龄、性别和种族不是效用评分的统计学显著独立预测因素。收入门槛低于10,000美元和高于10,000美元的人群在VAS（P = 0.049）和SG（P = 0.015）方面存在统计学显著差异。线性回归分析表明，医学教育与SG和TTO评分成正比（P < 0.05）。
重建乳房中NAC的缺失可以通过效用评分（VAS，0.84±0.18；TTO，0.92±0.11；SG，0.92±0.11）进行客观评估。与先前报道的情况相比，选择进行NAC重建的患者的生活质量与患有鼻畸形或需要年轻化的颈部老化的人的生活质量相似。
