Department of Breast Surgery, Ninewells Hospital and Medical School, Dundee DD2 1SG, UK.
Department of Breast Surgery, Ninewells Hospital and Medical School, Dundee DD2 1SG, UK.
J Plast Reconstr Aesthet Surg. 2024 Apr;91:218-224. doi: 10.1016/j.bjps.2024.01.030. Epub 2024 Feb 12.
Bilateral therapeutic mammoplasty (BTM) is commonly performed in the UK during treatment for breast cancer, and the available data show oncological safety. This study aims to compare patient-recorded outcome measures before and after surgery, as well as associated patient factors.
Between March 2018 and December 2019, patients undergoing BTM for breast cancer completed validated BREAST-Q reduction modules before and 3 months after surgery and a radiotherapy domain at 3 months. Scores were correlated with clinical data. For BREAST-Q scales, a higher score (0-100) represents greater satisfaction or quality of life.
28 patients were included, median age 58 years (IQR 52-64), BMI 32.0 (IQR 27.8-34.0). Of these, 1 had bilateral disease, 2 had multifocal disease, and the remaining had unilateral disease. Most (55%) underwent Wise pattern incision. At 3 months post-operatively, the following outcome scores improved based on the Wilcoxon signed-rank test: satisfaction with breasts (median 44 to 84; p < 0.001), psychosocial wellbeing (57.5 to 83; p < 0.001) and sexual wellbeing (48 to 61; p = 0.029). The improvement in satisfaction with breasts score correlated with the preoperative score (p = 0.011), with a larger increase in patients with a lower baseline score. Physical wellbeing was unchanged overall (median 71 to 72). In all solely post-operative domains (satisfaction with information, outcome, nipples and following radiation), patients reported high levels of satisfaction with outcomes.
Patients reported improved levels of patient-related quality of life measures after therapeutic mammoplasty, including satisfaction with breasts and psychosocial and sexual wellbeing, with high post-operative outcomes in satisfaction with outcome, information and nipples, as well as radiation Q-score.
双侧治疗性乳房切除术（BTM）在英国常用于乳腺癌的治疗，现有数据显示其具有肿瘤安全性。本研究旨在比较手术前后患者记录的结果测量指标，以及相关的患者因素。
在 2018 年 3 月至 2019 年 12 月期间，接受 BTM 治疗乳腺癌的患者在手术前和手术后 3 个月完成了经过验证的 BREAST-Q 减少模块，并在 3 个月时完成了放射治疗模块。评分与临床数据相关联。对于 BREAST-Q 量表，分数越高（0-100）代表满意度或生活质量越高。
共纳入 28 例患者，中位年龄 58 岁（IQR 52-64），BMI 为 32.0（IQR 27.8-34.0）。其中，1 例为双侧疾病，2 例为多灶性疾病，其余为单侧疾病。大多数患者（55%）采用 Wise 模式切口。术后 3 个月，根据 Wilcoxon 符号秩检验，以下结果评分改善：乳房满意度（中位数 44 至 84；p<0.001）、心理社会健康状况（57.5 至 83；p<0.001）和性健康状况（48 至 61；p=0.029）。乳房满意度评分的改善与术前评分相关（p=0.011），基线评分较低的患者改善幅度更大。整体身体健康状况无变化（中位数 71 至 72）。在所有仅术后领域（对信息、结果、乳头和放疗的满意度），患者对结果的满意度报告均较高。
BTM 治疗后，患者报告了更高水平的与患者相关的生活质量指标，包括对乳房的满意度以及心理社会和性健康状况，对结果、信息和乳头的满意度以及放射治疗 Q 评分的术后结果较高。
