From the Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center; and the Division of Plastic and Reconstructive Surgery, Department of Surgery, Brigham and Women's Hospital.
Plast Reconstr Surg. 2021 Dec 1;148(6):891e-902e. doi: 10.1097/PRS.0000000000008521.
This study aims to present normative values for satisfaction with breasts among preoperative breast reconstruction patients as assessed using the BREAST-Q instrument and to delineate factors associated with preoperative breast satisfaction.
A retrospective analysis of prospectively collected data was performed examining women undergoing postmastectomy breast reconstruction at a tertiary care center who preoperatively completed the BREAST-Q from 2010 to 2017. Because breast satisfaction scores were nonnormally distributed, scores were categorized into quartiles for analysis. Patient- and treatment-level variables were tested in a multivariable ordinal logistic regression model as predictors of breast satisfaction. Preoperative satisfaction was also tested for association with choice of reconstructive modality.
Among 1306 postmastectomy reconstruction patients included in the study, mean preoperative Satisfaction with Breasts score was 61.8 ± 21.5 and the median score was 58.0 (interquartile range, 48 to 70). Factors associated with significantly lower preoperative satisfaction included history of psychiatric diagnosis, preoperative radiotherapy, marital status (married), and higher body mass index. Factors associated with significantly higher scores were malignancy (localized tumor), medium bra size (B to C cup), and self-identification as black. Preoperative breast satisfaction was lower among patients who elected autologous reconstruction than among those with implant reconstruction (p < 0.001).
Preoperative breast satisfaction is influenced by multiple factors. Understanding these factors may improve preoperative counseling and expectation management for patients who undergo postmastectomy breast reconstruction.
CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.
本研究旨在通过 BREAST-Q 量表评估术前乳房重建患者对乳房的满意度，并描述与术前乳房满意度相关的因素，为患者提供术前乳房重建满意度的参考值。
对 2010 年至 2017 年在一家三级保健中心接受乳房再造术的患者进行前瞻性收集数据的回顾性分析，这些患者在术前完成了 BREAST-Q。由于乳房满意度评分呈非正态分布，因此将评分分为四分位数进行分析。采用多变量有序逻辑回归模型，对患者和治疗水平的变量进行检验，作为预测乳房满意度的因素。同时，还检验了术前满意度与重建方式选择的相关性。
在研究中纳入的 1306 例乳房再造术后患者中，平均术前乳房满意度评分（Satisfaction with Breasts score）为 61.8 ± 21.5，中位数为 58.0（四分位距，48 至 70）。与术前满意度显著降低相关的因素包括精神科诊断史、术前放疗、婚姻状况（已婚）和较高的体重指数。与评分显著升高相关的因素包括恶性肿瘤（局部肿瘤）、中等乳房尺寸（B 罩杯至 C 罩杯）和自我认同为黑人。与选择自体组织重建的患者相比，选择植入物重建的患者术前乳房满意度较低（p < 0.001）。
术前乳房满意度受多种因素影响。了解这些因素可能有助于改善接受乳房再造术的患者的术前咨询和期望管理。
临床问题/证据水平：风险，III 级。
