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保乳治疗中的肿瘤整形手术:患者概况及对生活质量的影响。

Oncoplastic Surgery in Breast-Conserving Treatment: Patient Profile and Impact on Quality of Life.

作者信息

de Oliveira-Junior Idam, da Silva Igor de Araujo, da Silva Fabíola Cristina Brandini, da Silva Jonathas José, Sarri Almir José, Paiva Carlos Eduardo, Vieira René Aloisio da Costa

机构信息

Department of Mastology and Breast Reconstruction, Barretos Cancer Hospital, Sao Paulo, Brazil.

Postgraduate Program of Gynecology, Obstetrics and Mastology, Botucatu Medical School, Sao Paulo State University - UNESP, Sao Paulo, Brazil.

出版信息

Breast Care (Basel). 2021 Jun;16(3):243-253. doi: 10.1159/000507240. Epub 2020 Jul 17.

Abstract

BACKGROUND

Breast-conserving treatment (BCT) provides better quality of life (QL) than mastectomy without reconstruction. Oncoplastic surgery (OS) encompasses a series of surgical techniques, increasing the indications for BCT, but few studies have evaluated the impact on QL in patients who undergo BCT with OS.

MATERIALS AND METHODS

A prospective, cross-sectional study was conducted in women who underwent BCT. We evaluated the characteristics of patients who underwent BCT with and without OS and the associated QL. QL was assessed through the EORTC QLQ-30, EORTC QLQ-BR23, and Breast Cancer Treatment Outcome Scale (BCTOS) questionnaires.

RESULTS

A total of 300 patients underwent BCT, 72 underwent breast OS, and 37 underwent bilateral surgery. Patients who underwent OS were younger ( = 0.004), had a higher level of education ( = 0.01), had a smaller time interval since the end of treatment ( = 0.02), had tumours with greater dimensions ( = 0.003), and were more likely to receive neoadjuvant chemotherapy ( = 0.05). Based on the QL questionnaires, no difference was observed between the groups. Breast symmetry was not associated with high patient satisfaction ( = 0.55).

CONCLUSION

Despite the fact that OS was performed in patients with worse tumour conditions and in more demanding patients, OS allowed similar cosmetic results to classical BCT.

摘要

背景

保乳治疗(BCT)比未行乳房重建的乳房切除术能提供更好的生活质量(QL)。肿瘤整形手术(OS)涵盖一系列手术技术,增加了保乳治疗的适应症,但很少有研究评估其对接受保乳治疗联合肿瘤整形手术患者生活质量的影响。

材料与方法

对接受保乳治疗的女性进行了一项前瞻性横断面研究。我们评估了接受和未接受肿瘤整形手术的保乳治疗患者的特征以及相关的生活质量。通过欧洲癌症研究与治疗组织生活质量问卷核心30条目(EORTC QLQ - 30)、欧洲癌症研究与治疗组织乳腺癌特异性问卷(EORTC QLQ - BR23)和乳腺癌治疗结果量表(BCTOS)问卷评估生活质量。

结果

共有300例患者接受了保乳治疗,72例接受了乳房肿瘤整形手术,37例接受了双侧手术。接受肿瘤整形手术的患者更年轻(P = 0.004),受教育程度更高(P = 0.01),治疗结束后的时间间隔更短(P = 0.02),肿瘤尺寸更大(P = 0.003),且更有可能接受新辅助化疗(P = 0.05)。根据生活质量问卷,两组之间未观察到差异。乳房对称性与患者高满意度无关(P = 0.55)。

结论

尽管肿瘤整形手术是在肿瘤情况较差和要求更高的患者中进行的,但肿瘤整形手术能产生与传统保乳治疗相似的美容效果。

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