Department of Surgery, University of California Los Angeles, Los Angeles, CA, USA.
Brown University and the Lifespan Cancer Institute, Providence, RI, USA.
Ann Surg Oncol. 2021 May;28(5):2493-2505. doi: 10.1245/s10434-020-09448-9. Epub 2021 Jan 3.
The Going Flat movement aims to increase awareness and acceptance of mastectomy alone as a viable option for patients. Little is known about motivations and satisfaction with surgical outcomes in this population.
An online survey was administered to 931 women who had a history of uni- or bilateral mastectomy for treatment of breast cancer or elevated breast cancer risk without current breast mound reconstruction. Satisfaction with outcome and surgeon support for the patient experience were characterized using 5-level scaled scores.
Mastectomy alone was the first choice for 73.7% of the respondents. The top two reasons for going flat were desire for a faster recovery and avoidance of a foreign body placement. Overall, the mean scaled satisfaction score was 3.72 ± 1.17 out of 5. In the multivariable analysis, low level of surgeon support for the decision to go flat was the strongest predictor of a satisfaction score lower than 3 (odds ratio [OR], 3.85; 95% confidence interval [CI], 2.59-5.72; p < 0.001). Dissatisfaction also was more likely among respondents reporting a body mass index (BMI) of 30 kg/m or higher (OR, 2.74; 95% CI, 1.76-4.27; p < 0.001) and those undergoing a unilateral procedure (OR, 1.99; 95% CI, 1.29-3.09; p = 0.002). Greater satisfaction was associated with receiving adequate information about surgical options (OR, 0.48; 95% CI, 0.32-0.69; p < 0.0001) and having a surgeon with a specialized breast surgery practice (OR, 0.56; 95% CI, 0.38-0.81; p = 0.002).
Most patients undergoing mastectomy alone are satisfied with their surgical outcome. Surgeons may optimize patient experience by recognizing and supporting a patient's decision to go flat.
“平胸运动”旨在提高人们对仅接受乳房切除术作为乳腺癌或高乳腺癌风险患者的可行选择的认识和接受度。对于该人群，对手术结果的动机和满意度知之甚少。
对 931 名曾因乳腺癌或升高的乳腺癌风险而接受单侧或双侧乳房切除术但目前未行乳房隆乳术的女性进行了在线调查。采用 5 级评分量表评估对手术结果的满意度和外科医生对患者体验的支持程度。
73.7%的受访者首选单纯乳房切除术。选择平胸的前两个原因是渴望更快恢复和避免异物放置。总体而言，平均评分满意度为 5 分制中的 3.72±1.17 分。在多变量分析中，外科医生对选择平胸的支持程度低是满意度评分低于 3 的最强预测因素（比值比[OR]，3.85；95%置信区间[CI]，2.59-5.72；p<0.001）。报告 BMI 为 30kg/m2 或更高（OR，2.74；95%CI，1.76-4.27；p<0.001）或行单侧手术（OR，1.99；95%CI，1.29-3.09；p=0.002）的患者更有可能不满意。获得有关手术选择的充分信息（OR，0.48；95%CI，0.32-0.69；p<0.0001）和外科医生具有专业的乳房手术实践（OR，0.56；95%CI，0.38-0.81；p=0.002）与更高的满意度相关。
大多数接受单纯乳房切除术的患者对手术结果满意。外科医生可以通过识别和支持患者选择平胸来优化患者体验。
