Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
Ann Surg Oncol. 2018 Oct;25(10):3044-3051. doi: 10.1245/s10434-018-6606-3. Epub 2018 Jun 26.
We sought to determine the impact of time after surgery on quality of life (QoL) and body image in breast cancer patients undergoing mastectomy.
Female patients with unilateral breast cancer who had undergone mastectomy were surveyed regarding their body image (Body Image After Breast Cancer Questionnaire; BIBCQ) and QoL (FACT-B). Data were analyzed using nonparametric statistics (SPSS version 24).
Ninety-four of the 109 patients approached completed both surveys (86.2% response rate). Median patient age at the time of surgery was 49.5 (range 29-82); the survey was administered at a median of 14.2 months postoperatively (range 0.3-192.1 months). Seventy-four patients (78.7%) had reconstruction, and 52 patients (55.3%) chose to undergo contralateral prophylactic mastectomy. Patients who reported an above average overall body image perception on the BIBCQ tended to be further out from their surgery than those who reported a below average perception (median 20.9 vs. 8.1 months, respectively, p = 0.009). Patients who reported above average QoL also tended to be further out from their surgery compared with those with below average overall QoL (median 21.8 vs. 6.4 months, respectively, p = 0.004). Receipt of reconstruction, contralateral prophylactic mastectomy, disease stage, patient race, education, insurance type, income, marital status, employment status, and age at surgery did not significantly affect body image nor QoL in this cohort.
Better body image perception and higher QoL were associated with being further out from surgery. These findings suggest that body image and QoL may improve with time, as patients acclimatize to their "new normal."
我们旨在探讨乳腺癌患者行乳房切除术术后时间对生活质量(QoL)和身体形象的影响。
对接受乳房切除术的单侧乳腺癌女性患者进行身体形象(乳腺癌患者身体形象问卷;BIBCQ)和生活质量(FACT-B)调查。使用非参数统计(SPSS 版本 24)分析数据。
在 109 名接受调查的患者中,有 94 名完成了两项调查(86.2%的应答率)。手术时患者的中位年龄为 49.5 岁(范围 29-82 岁);调查在术后中位数 14.2 个月(范围 0.3-192.1 个月)时进行。74 名患者(78.7%)接受了重建,52 名患者(55.3%)选择接受对侧预防性乳房切除术。BIBCQ 总体身体形象感知评分较高的患者比评分较低的患者手术时间更久(中位数分别为 20.9 个月和 8.1 个月,p=0.009)。报告 QoL 评分较高的患者也比报告总体 QoL 评分较低的患者手术时间更久(中位数分别为 21.8 个月和 6.4 个月,p=0.004)。在该队列中,接受重建、对侧预防性乳房切除术、疾病分期、患者种族、教育程度、保险类型、收入、婚姻状况、就业状况和手术年龄均未显著影响身体形象或生活质量。
更好的身体形象感知和更高的 QoL 与手术时间更久相关。这些发现表明,随着患者适应他们的“新常态”,身体形象和 QoL 可能会随着时间的推移而改善。