Liu Liang Q, Branford Olivier A, Mehigan Sinead
Department of Adult, Child & Midwifery, School of Health and Education, Centre for Critical Research in Nursing and Midwifery, Middlesex University, The Burroughs, London, United Kingdom.
Department of Plastic Surgery, Queen Victoria Hospital, West Sussex, United Kingdom.
Plast Reconstr Surg Glob Open. 2018 Aug 7;6(8):e1904. doi: 10.1097/GOX.0000000000001904. eCollection 2018 Aug.
Since BREAST-Q was developed in 2009, it has been widely used by clinicians and researchers to capture information regarding health-related quality of life (HRQoL) and patient satisfaction related to breast surgery. Yet clinical guidelines regarding the use of BREAST-Q for assessment of success of surgery in women with breast cancer remain limited. To maximize the benefits of using BREAST-Q to inform clinical decision making, this systematic review aimed to identify and appraise current evidence on patient-reported outcomes (PROs) assessed by BREAST-Q associated with breast oncoplastic surgery.
A detailed search strategy was implemented and electronic databases searched include PubMed, MEDLINE, CINAHL, and PsycINFO. Review was limited to peer-reviewed studies published in English from 2009 to January 2018. Any interventional and observational studies that used BREAST-Q to assess PROs in the assessment of breast oncoplastic surgery were included.
Fifty-four peer-reviewed articles met inclusion criteria. Fifty-three studies were observational, 1 study was interventional. Current comparative studies using BREAST-Q indicated that abdominal flap, buttock flap, or thigh flap reconstruction offered highest satisfaction with breast; contralateral prophylactic mastectomy with immediate reconstruction offered higher levels of satisfaction with breast, but poor postsurgical physical well-being. Silicone implant and no radiation therapy offered higher level satisfaction and HRQoL.
Current evidence showed that BREAST-Q can effectively measure patient's satisfaction and HRQoL in relation to different type of breast oncoplastic surgeries. BREAST-Q captured meaningful and reliable information from the patients' perspective and may be useful for clinical decision making.
自2009年BREAST-Q开发以来,临床医生和研究人员广泛使用它来获取与健康相关的生活质量(HRQoL)以及与乳房手术相关的患者满意度的信息。然而,关于使用BREAST-Q评估乳腺癌女性手术成功率的临床指南仍然有限。为了最大限度地利用BREAST-Q为临床决策提供信息,本系统评价旨在识别和评估目前关于通过BREAST-Q评估的与乳房肿瘤整形手术相关的患者报告结局(PROs)的证据。
实施了详细的检索策略,检索的电子数据库包括PubMed、MEDLINE、CINAHL和PsycINFO。综述仅限于2009年至2018年1月以英文发表的同行评审研究。纳入任何使用BREAST-Q评估乳房肿瘤整形手术中PROs的干预性和观察性研究。
54篇同行评审文章符合纳入标准。53项研究为观察性研究,1项研究为干预性研究。目前使用BREAST-Q的比较研究表明,腹部皮瓣、臀部皮瓣或大腿皮瓣重建术患者对乳房的满意度最高;即刻重建的对侧预防性乳房切除术患者对乳房的满意度较高,但术后身体状况较差。硅胶植入且未接受放疗的患者满意度和HRQoL较高。
目前的证据表明,BREAST-Q可以有效测量患者对不同类型乳房肿瘤整形手术的满意度和HRQoL。BREAST-Q从患者角度获取了有意义且可靠的信息,可能有助于临床决策。