From the Adolescent Breast Center, the Department of Plastic and Oral Surgery, Boston Children's Hospital; and the Division of Adolescent/Young Adult Medicine, Boston Children's Hospital and Harvard Medical School.
Plast Reconstr Surg. 2020 Oct;146(4):400e-408e. doi: 10.1097/PRS.0000000000007149.
Young women with congenital breast asymmetry have impaired psychological well-being and self-esteem. However, little is known regarding the effects of surgical intervention in this population. This cohort study aims to assess postoperative changes in health-related quality of life following surgical treatment of breast asymmetry in young women using a prospective, longitudinal study design.
From 2008 to 2018, 45 young women undergoing surgical correction of breast asymmetry of benign cause and 101 unaffected, female controls completed the following surveys: Short-Form 36v2, Rosenberg Self-Esteem Scale, and Eating-Attitudes Test-26. Surveys were administered at baseline and at up to 9-year follow-up.
Participants with breast asymmetry scored significantly worse than controls at baseline on the Rosenberg Self-Esteem Scale and in two Short-Form 36v2 domains: Social-Functioning and Role-Emotional. Asymmetry participants experienced significant postoperative improvements on the Rosenberg Self-Esteem Scale, and in three Short-Form 36v2 domains: Role-Physical, Social Functioning, and Mental Health. These improvements were sustained for a minimum of 5 years. Postoperatively, asymmetry participants' quality of life was comparable to controls and did not vary by age at the time of surgery, asymmetry severity, or diagnosis.
Surgical treatment of breast asymmetry in young women yields significant and sustained improvements in psychosocial quality of life. Postoperatively, patients returned to a level of functioning commensurate with their peers.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, IV.
患有先天性乳房不对称的年轻女性心理健康和自尊心受损。然而,对于该人群的手术干预效果知之甚少。本队列研究旨在通过前瞻性、纵向研究设计,评估年轻女性因良性原因接受乳房不对称手术矫正后,健康相关生活质量的术后变化。
2008 年至 2018 年,45 名因良性原因接受乳房不对称手术矫正的年轻女性和 101 名未受影响的女性对照组完成了以下调查:简短表格 36 版 2 项(Short-Form 36v2)、罗森伯格自尊量表(Rosenberg Self-Esteem Scale)和饮食态度测试 26 项(Eating-Attitudes Test-26)。调查在基线和最多 9 年的随访时进行。
乳房不对称的参与者在基线时的罗森伯格自尊量表和两个简短表格 36 版 2 项评分(社交功能和角色情感)上明显差于对照组。不对称参与者在罗森伯格自尊量表和三个简短表格 36 版 2 项评分(身体角色、社交功能和心理健康)上经历了显著的术后改善。这些改善持续了至少 5 年。术后,不对称参与者的生活质量与对照组相当,并且与手术时的年龄、不对称严重程度或诊断无关。
年轻女性乳房不对称的手术治疗可显著改善社会心理生活质量,并持续改善。术后,患者的功能恢复到与其同龄人相当的水平。
临床问题/证据水平:治疗,IV。