Department of Plastic and Reconstructive Surgery, Flinders Medical Centre, Bedford Park, South Australia, Australia.
Discipline of Surgery, College of Medicine and Public Health, Flinders University, Bedford Park, South Australia, Australia.
BMJ Open. 2020 Feb 17;10(2):e031804. doi: 10.1136/bmjopen-2019-031804.
To assess the health burden of breast hypertrophy and the comparative effectiveness of breast reduction surgery in improving health-related quality of life.
Prospective cohort study.
A major public tertiary care hospital in Australia.
Women with symptomatic breast hypertrophy who underwent breast reduction surgery were followed for 12 months. A comparison control cohort comprised women with breast hypertrophy who did not undergo surgery.
Bilateral breast reduction surgery for women in the surgical cohort.
The primary outcome measure was health-related quality of life measured preoperatively and at 3, 6 and 12 months postoperatively using the Short Form-36 (SF-36) questionnaire. Secondary outcome measures included post-surgical complications.
209 patients in the surgical cohort completed questionnaires before and after surgery. 124 patients in the control hypertrophy cohort completed baseline and 12-month follow-up questionnaires. At baseline, both groups had significantly lower scores compared with population norms across all scales (p<0.001). In the surgical cohort significant improvements were seen across all eight SF-36 scales (p<0.001) following surgery. Within 3 months of surgery scores were equivalent to those of the normal population and this improvement was sustained at 12 months. SF-36 physical and mental component scores both significantly improved following surgery, with a mean change of 10.2 and 9.2 points, respectively (p<0.001). In contrast, SF-36 scores for breast hypertrophy controls remained at baseline across 12 months. The improvement in quality of life was independent of breast resection weight and body mass index.
Breast reduction significantly improved quality of life in women with breast hypertrophy. This increase was most pronounced within 3 months of surgery and sustained at 12-month follow-up. This improvement in quality of life is comparable to other widely accepted surgical procedures. Furthermore, women benefit from surgery regardless of factors including body mass index and resection weight.
评估乳房肥大的健康负担以及乳房缩小手术改善健康相关生活质量的效果。
前瞻性队列研究。
澳大利亚一家主要的公立三级保健医院。
接受乳房缩小手术的有症状乳房肥大的女性，随访 12 个月。对照组为未行手术的乳房肥大女性。
手术组中女性行双侧乳房缩小术。
采用简明健康状况调查问卷（SF-36），在术前及术后 3、6 和 12 个月测量健康相关生活质量，作为主要结局测量指标。次要结局测量指标包括术后并发症。
手术组 209 例患者完成了手术前后的问卷调查，对照组 124 例乳房肥大患者完成了基线和 12 个月的随访问卷调查。基线时，两组在所有量表上的评分均显著低于人群正常值（均 p<0.001）。在手术组中，所有 8 个 SF-36 量表在手术后均显著改善（均 p<0.001）。术后 3 个月内，评分与正常人群相当，这种改善在 12 个月时仍保持。SF-36 生理和心理分量表评分在手术后均显著改善，分别平均改善 10.2 和 9.2 分（均 p<0.001）。相比之下，乳房肥大对照组的 SF-36 评分在 12 个月时仍保持在基线水平。生活质量的改善与乳房切除重量和体重指数无关。
乳房缩小术显著改善了乳房肥大女性的生活质量。这种改善在手术后 3 个月内最为明显，并在 12 个月的随访中持续存在。这种生活质量的改善与其他广泛接受的手术相当。此外，无论体重指数和切除重量等因素如何，女性都能从手术中获益。
