Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
Ann Surg Oncol. 2024 Oct;31(10):6602-6610. doi: 10.1245/s10434-024-15310-z. Epub 2024 Aug 1.
The role that preoperative Satisfaction with Breast plays in a patient's postoperative course after postmastectomy breast reconstruction (PMBR) is not understood. The aim of this study is to understand the impact of the preoperative score on postoperative outcome as an independent variable.
We examined patients who underwent PMBR between 2017 and 2021 and who completed the BREAST-Q Satisfaction with Breasts at 1 year postoperatively. Two multiple linear regression models (Model 1 with the preoperative Satisfaction with Breasts score and Model 2 without the preoperative score), likelihood ratio tests, simple t-statistics, and sample patient dataset to predict the 1 year score were performed. Multiple imputation was used to account for missing preoperative scores.
Overall, 2324 patients were included. Model 1 showed that the preoperative score is significantly associated with the postoperative score (β = 0.09, 95% confidence interval 0.04-0.14; p < 0.001). Comparing Model 1 and Model 2 demonstrated that including preoperative Satisfaction with Breasts in a regression significantly improves model fit (test statistic = 10.04; p = 0.0021). Using the absolute value of the t-statistics as a measure of variable importance in linear regression, the importance of the preoperative score was quantified as 3.39-more important than neoadjuvant radiation, mastectomy weight, body mass index, bilateral prophylactic mastectomy, and race, but less than adjuvant radiation, reconstruction type, and psychiatric diagnoses.
Preoperative Satisfaction with Breasts scores are an important independent predictor of postoperative satisfaction after PMBR. Just as vital sign and work-up are carefully documented before surgery, preoperative scores should be collected to pre-emptively gauge patients' satisfaction and optimize postoperative outcomes.
术前乳房满意度在乳腺癌根治术后乳房重建（PMBR）患者的术后过程中所扮演的角色尚未被理解。本研究旨在作为独立变量，了解术前评分对术后结果的影响。
我们对 2017 年至 2021 年间接受 PMBR 且术后 1 年完成 BREAST-Q 乳房满意度评估的患者进行了研究。采用了两种多元线性回归模型（包含术前乳房满意度评分的模型 1 和不包含术前评分的模型 2）、似然比检验、简单 t 检验和样本患者数据集，以预测 1 年评分。采用多重插补法处理缺失的术前评分。
总体而言，共纳入了 2324 名患者。模型 1 表明术前评分与术后评分显著相关（β=0.09，95%置信区间 0.04-0.14；p<0.001）。比较模型 1 和模型 2 表明，在回归中包含术前乳房满意度评分可显著提高模型拟合度（检验统计量=10.04；p=0.0021）。线性回归中，采用 t 统计量的绝对值作为衡量变量重要性的指标，术前评分的重要性被量化为 3.39，比新辅助放疗、乳房切除术重量、体重指数、双侧预防性乳房切除术和种族更重要，但比辅助放疗、重建类型和精神科诊断更不重要。
术前乳房满意度评分是 PMBR 后患者术后满意度的重要独立预测指标。正如术前仔细记录生命体征和检查结果一样，应收集术前评分，以预先评估患者的满意度并优化术后结果。
