Barbalho Daniel, Polidorio Natalia, Mori Lincon, Barros Alfredo, Sampaio Marcelo, Melo Sandro, Assis Amilcar, Bioni Pamela, Miziara Giovanna, Fraga Murilo, Andrade Felipe
Department of Breast Surgical Oncology, Hospital Sírio-Libanês, Brasília, Brazil.
Department of Breast Surgical Oncology, Hospital Sírio-Libanês, São Paulo, Brazil.
Front Oncol. 2024 Oct 18;14:1465769. doi: 10.3389/fonc.2024.1465769. eCollection 2024.
Local treatment can be distressful to breast cancer patients. We aimed to evaluate how different types of local treatment impact the quality of life of patients.
In this retrospective cohort study, one-year postoperative Breast-Q Satisfaction with Breasts scores were used as a surrogate for Quality of Life. Linear regression was used to estimate the impact of breast conservation, oncoplastic surgery, breast reconstruction, and radiation therapy on Breast-Q scores. All analyses were adjusted for multiple covariates.
Of the 711 eligible patients, 349 female patients answered both the pre- and one-year postoperative questionnaires and were included in the final analysis. In total, 237 (68%) patients underwent breast-conserving surgeries and 112 (32%) underwent mastectomies. All mastectomy patients underwent breast reconstruction and 176 (74% of breast-conserving surgeries) underwent concomitant oncoplastic surgery. After multivariate analysis, mastectomy was associated with lower scores compared to breast-conserving surgery (-21.3; 95%CI: -36.2, -6.4, p=0.005), and oncoplastic surgery was associated with higher scores (9.2; 95%CI: 0.8, 17.6, p=0.032). There was a tendency for higher scores with the use of flaps in breast reconstruction and a tendency for lower scores with the use of radiation therapy, but the difference was not significant.
Breast-conserving surgery is associated with better quality of life than mastectomy. Additionally, oncoplastic surgery is associated with a better quality of life than standard breast-conserving surgery. Patients should be counseled whenever multiple options for surgery are possible, and efforts should be made to increase the availability of trained surgeons in oncoplastic techniques.
局部治疗可能会给乳腺癌患者带来痛苦。我们旨在评估不同类型的局部治疗如何影响患者的生活质量。
在这项回顾性队列研究中，将术后一年的乳房Q乳房满意度评分用作生活质量的替代指标。采用线性回归来估计保乳手术、肿瘤整形手术、乳房重建和放射治疗对乳房Q评分的影响。所有分析均针对多个协变量进行了调整。
在711名符合条件的患者中，349名女性患者回答了术前和术后一年的问卷，并纳入最终分析。总共有237名（68%）患者接受了保乳手术，112名（32%）患者接受了乳房切除术。所有乳房切除术患者均接受了乳房重建，176名（保乳手术患者的74%）接受了同期肿瘤整形手术。多变量分析后，与保乳手术相比，乳房切除术与较低的评分相关（-21.3；95%置信区间：-36.2，-6.4，p=0.005），肿瘤整形手术与较高的评分相关（9.2；95%置信区间：0.8，17.6，p=0.032）。乳房重建中使用皮瓣有评分较高的趋势，使用放射治疗有评分较低的趋势，但差异不显著。
保乳手术与比乳房切除术更好的生活质量相关。此外，肿瘤整形手术与比标准保乳手术更好的生活质量相关。只要有多种手术选择，就应向患者提供咨询，并应努力增加掌握肿瘤整形技术的外科医生的可及性。
