Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States.
Department of Surgery, Section of Plastic Surgery, University of Michigan, Ann Arbor, MI, United States.
J Plast Reconstr Aesthet Surg. 2023 Aug;83:51-56. doi: 10.1016/j.bjps.2023.04.032. Epub 2023 Apr 19.
Patients with Stage IV breast cancer are living longer but breast reconstruction in this setting remains controversial. There is limited research evaluating the benefits of breast reconstruction in this patient cohort.
Drawing from the Mastectomy Reconstruction Outcomes Consortium (MROC) dataset, a prospective cohort study that involved 11 leading medical centers in the US and Canada, we compared patient-reported outcomes (PROs) assessed utilizing the BREAST-Q, a condition-specific, validated patient-reported outcome measure (PROM) for mastectomy reconstruction, as well as complications between a cohort of patients with Stage IV disease undergoing reconstruction and a control group of women with Stage I-III disease also receiving reconstruction.
Among the MROC population, 26 patients with Stage IV and 2613 women with Stage I-III breast cancer underwent breast reconstruction. Preoperatively, the Stage IV cohort reported significantly lower baseline scores for satisfaction with breast (p = 0.004), psychosocial well-being (p = 0.043) and sexual well-being (p = 0.001), compared with Stage I-III women. Following breast reconstruction, Stage IV patients' mean PRO scores improved over baseline and were not significantly different from those of Stage I-III reconstruction patients. There were also no significant differences in overall/any (p = 0.782), major (p = 0.751) or minor complication (p = 0.787) rates between the two groups at two years following reconstruction.
The findings in this study suggest that breast reconstruction offers significant quality-of-life benefits for women with advanced breast cancer with no increase in postoperative complications and thus may be a reasonable option in this clinical setting.
患有 IV 期乳腺癌的患者存活时间更长，但在这种情况下进行乳房重建仍然存在争议。有限的研究评估了在这一患者群体中进行乳房重建的益处。
本研究基于美国和加拿大 11 家领先医疗中心参与的乳房切除术重建结果联盟（MROC）数据集，这是一项前瞻性队列研究，我们比较了接受重建的 IV 期疾病患者队列和接受重建的 I-III 期疾病女性对照组的患者报告结局（PROs），并使用 BREAST-Q 进行评估，这是一种针对乳房切除术重建的特定的、经过验证的患者报告结局测量（PROM）。
在 MROC 人群中，26 例 IV 期患者和 2613 例 I-III 期乳腺癌患者接受了乳房重建。术前，IV 期患者报告在乳房满意度（p=0.004）、心理社会健康（p=0.043）和性健康（p=0.001）方面的基线评分明显低于 I-III 期女性。乳房重建后，IV 期患者的平均 PRO 评分较基线有所提高，与 I-III 期重建患者无显著差异。两组患者在术后两年时，总体/任何（p=0.782）、主要（p=0.751）或次要并发症（p=0.787）的发生率均无显著差异。
本研究的结果表明，乳房重建为晚期乳腺癌患者提供了显著的生活质量益处，且不会增加术后并发症，因此在这种临床情况下可能是一种合理的选择。
