Boudry Thibaud, Maisonnette Escot Yolande, Pluvy Isabelle, Feuvrier Damien, Houvenaeghel Gilles, Ramanah Rajeev
Département de chirurgie gynécologie et obstétrique, centre hospitalier universitaire Jean-Minjoz, université de Franche-Comté, 3, boulevard Alexander-Fleming, 25030 Besançon cedex, France.
Département de chirurgie gynécologie et obstétrique, centre hospitalier universitaire Jean-Minjoz, université de Franche-Comté, 3, boulevard Alexander-Fleming, 25030 Besançon cedex, France.
Gynecol Obstet Fertil Senol. 2024 Sep;52(9):517-523. doi: 10.1016/j.gofs.2024.03.006. Epub 2024 Mar 19.
Breast reconstruction after mastectomy, whether immediate or delayed, is an integral part of the overall management of breast cancer. However, up to 40 % of reconstructed patients are not satisfied with the aesthetic result. The primary objective of the study was to evaluate satisfaction and quality of life according to the reconstruction techniques used in our center. The secondary objectives were to identify the parameters that could influence satisfaction and quality of life after surgery, to list the main complications, and the number of operations required to consider the reconstruction process as completed.
A retrospective monocentric study, RECOMA, was carried out at the CHRU Minjoz in Besançon. All patients who underwent immediate or delayed breast reconstruction between 2010 and 2021 were contacted by post or e-mail and asked to complete the standardized BREAST-Q postoperative module.
Of 508 patients contacted, 149 were included. Reconstructed patients reported satisfaction, but also "average" quality of physical and psychological sexual life. Only the surgeon's assessment was rated as "good". There was no significant difference in satisfaction and quality of life depending on the reconstruction method chosen. On the other hand, patients who underwent nipple areolar complex (NAC) reconstruction had a significantly higher psychic quality of life score (P=0.02). In addition, a significant decrease in physical satisfaction was observed over time(P=0.049). An average of 2.4 operations was required to consider breast reconstruction complete.
In our opinion, breast reconstruction is an essential procedure to be considered as soon as the indication for mastectomy is given, but it is a process that requires the patient to be prepared for a result that may be weaker than expected, may require several operations, and may be complicated.
乳房切除术后的乳房重建，无论是即刻重建还是延迟重建，都是乳腺癌综合治疗的一个组成部分。然而，高达40%的接受重建的患者对美学效果不满意。本研究的主要目的是根据我们中心使用的重建技术评估患者的满意度和生活质量。次要目的是确定可能影响术后满意度和生活质量的参数，列出主要并发症，以及将重建过程视为完成所需的手术次数。
在贝桑松的CHRU Minjoz进行了一项回顾性单中心研究RECOMA。通过邮寄或电子邮件联系了2010年至2021年间接受即刻或延迟乳房重建的所有患者，并要求他们完成标准化的BREAST-Q术后模块。
在联系的508名患者中，149名被纳入研究。接受重建的患者报告了满意度，但也报告了身体和心理性生活的“一般”质量。只有外科医生的评估被评为“良好”。根据所选的重建方法，满意度和生活质量没有显著差异。另一方面，接受乳头乳晕复合体（NAC）重建的患者的心理生活质量得分显著更高（P=0.02）。此外，随着时间的推移，身体满意度显著下降（P=0.049）。平均需要2.4次手术才能认为乳房重建完成。
我们认为，乳房重建是在给出乳房切除指征后应尽快考虑的一项重要手术，但这是一个需要患者为可能比预期更差、可能需要多次手术且可能出现并发症的结果做好准备的过程。
