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肿瘤整形与乳房重建手术中的患者满意度、美学效果及生活质量:单中心经验

Patient Satisfaction, Esthetic Outcome, and Quality of Life in Oncoplastic and Reconstructive Breast Surgery: A Single Center Experience.

作者信息

Bolliger Michael, Gambone Luca, Haeusler Theresa, Mikula Fanny, Kampf Stephanie, Fitzal Florian

机构信息

Department of Surgery, Medical University of Vienna, Vienna, Austria.

Breast Health Center, Comprehensive Cancer Center Vienna, Medical University of Vienna, Vienna, Austria.

出版信息

Breast Care (Basel). 2024 Aug;19(4):215-222. doi: 10.1159/000540037. Epub 2024 Jul 22.

Abstract

BACKGROUND

Oncoplastic surgery has become an important part of the surgical repertoire to offer both oncologically safe and aesthetically pleasing results in patients with breast cancer. Data comparing oncoplastic and reconstructive breast surgeries are limited. This study aimed to assess patient-reported outcomes (PRO) in our cohort of oncoplastic and reconstructively operated patients.

METHODS

Patients who underwent oncoplastic surgery, including immediate reconstruction by a single surgeon, between 2010 and 2018 were contacted to participate in this study. In total, 157 patients fulfilled the inclusion criteria. 54 patient data sets were used for statistical evaluation. Body Image Scale (BIS) and BreastQ questionnaires were used to measure subjective PRO scores, and pictures were taken to objectively measure symmetry using the Breast Analyzing Tool (BAT). Patients were divided into three groups according to the Tübingen classification (group 1: Tübingen 3-4 ( = 16), group 2: Tübingen 5 ( = 26), group 3: Breast Reconstruction/Tübingen 6 ( = 12]).

RESULTS

The mean age was 53.5 for group 1, 51.4 for group 2 and 46.8 for group 3. The mean follow-up was 62.9 ± 35.82 months. BIS was significantly better in group 3 (3.92 ± 1.73) than in group 1 and 2 (7.69 ± 4.48 and 4.81 ± 3.41, = 0.016). Symmetry measured using BAT showed only a trend favoring reconstruction ( = 0.12). The BreastQ item "Sexual well-being" was significantly better in oncoplastic breast reduction surgery ( = 0.036).

CONCLUSION

BIS was better after reconstructive breast surgery than after oncoplastic surgery. Reconstructive breast surgery in experienced breast care units offers high patient satisfaction and a high quality of life.

摘要

背景

肿瘤整形手术已成为外科手术方法的重要组成部分,可为乳腺癌患者提供肿瘤学上安全且美观的手术效果。比较肿瘤整形手术和乳房重建手术的数据有限。本研究旨在评估我们队列中接受肿瘤整形手术和乳房重建手术患者的患者报告结局(PRO)。

方法

联系了2010年至2018年间接受肿瘤整形手术(包括由单一外科医生进行即刻重建)的患者参与本研究。共有157名患者符合纳入标准。54份患者数据集用于统计评估。使用身体意象量表(BIS)和乳房问卷(BreastQ)来测量主观PRO评分,并使用乳房分析工具(BAT)拍摄照片以客观测量对称性。根据图宾根分类将患者分为三组(第1组:图宾根3 - 4级(n = 16),第2组:图宾根5级(n = 26),第3组:乳房重建/图宾根6级(n = 12))。

结果

第1组的平均年龄为53.5岁,第2组为51.4岁,第3组为46.8岁。平均随访时间为62.9±35.82个月。第3组的BIS(3.92±1.73)明显优于第1组和第2组(7.69±4.48和4.81±3.41,P = 0.016)。使用BAT测量的对称性仅显示出有利于重建的趋势(P = 0.12)。乳房问卷中的“性健康”项目在肿瘤整形性乳房缩小手术中明显更好(P = 0.036)。

结论

乳房重建手术后的BIS优于肿瘤整形手术后的BIS。在经验丰富的乳房护理单位进行乳房重建手术可使患者满意度高且生活质量高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/90ee/11341076/a39835a4029b/brc-2024-0019-0004-540037_F01.jpg

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