Soroudi Daniel, Parmeshwar Nisha, Gozali Aileen, Piper Merisa
School of Medicine, University of California San Francisco, San Francisco, CA, USA.
Division of Plastic and Reconstructive Surgery, Department of Surgery, University of California San Francisco, San Francisco, CA, USA.
Ann Surg Oncol. 2025 Apr 18. doi: 10.1245/s10434-025-17288-8.
Understanding the psychosocial impact of mastectomy is crucial for guiding patient decisions on breast reconstruction. The BREAST-Q survey has been instrumental in assessing patient satisfaction. This study examines patient-reported outcomes and experiences with post-mastectomy flat closure, aiming to refine decision-making support for this option.
A retrospective review analyzed flat closure outcomes post-mastectomy, examining patient demographics, surgical details, and complications. Following consent, patients completed the BREAST-Q survey, rating satisfaction and factors influencing their choice for flat closure. The study also included qualitative analysis from patient emails, employing an inductive, triangulated approach to extract themes and provide a multifaceted understanding of the post-surgical experience.
Overall, 252 patients underwent flat closure post-mastectomy. The overall postoperative complication rate was 17.5% (n = 44); 19.8% (n = 50) completed the BREAST-Q survey, reporting high satisfaction with their surgeons, moderate satisfaction with their breasts, and high physical well-being. Survey results illuminated reasons for choosing flat closure, such as lower complication rates and avoidance of foreign objects. Furthermore, qualitative feedback from 15 email correspondents revealed some limitations of the survey's relevance and language, highlighting emotional impacts and a desire to improve future surveys.
This study distills the flat closure experience post-mastectomy, highlighting its viability and alignment with patient preferences for fewer complications and quicker recovery. It reveals the BREAST-Q's limitations in fully capturing patients' nuanced experiences, underscoring the necessity for more tailored data collection methods. Future research must refine patient-reported outcome measures (PROMs) and ensure flat closure is a routinely discussed option in post-mastectomy care.
了解乳房切除术的心理社会影响对于指导患者进行乳房重建决策至关重要。BREAST-Q 调查有助于评估患者满意度。本研究调查患者报告的乳房切除术后直接缝合的结果和体验，旨在优化对此选项的决策支持。
一项回顾性分析研究了乳房切除术后直接缝合的结果，检查了患者的人口统计学特征、手术细节和并发症。在获得同意后，患者完成了 BREAST-Q 调查，对满意度以及影响他们选择直接缝合的因素进行评分。该研究还包括对患者电子邮件的定性分析，采用归纳、三角测量法提取主题，并对术后体验进行多方面的理解。
总体而言，252 例患者在乳房切除术后接受了直接缝合。术后总体并发症发生率为 17.5%（n = 44）；19.8%（n = 50）完成了 BREAST-Q 调查，报告对其外科医生高度满意，对乳房中度满意，身体状况良好。调查结果阐明了选择直接缝合的原因，如较低的并发症发生率和避免异物。此外，15 位电子邮件受访者的定性反馈揭示了该调查在相关性和语言方面的一些局限性，突出了情感影响以及改进未来调查的愿望。
本研究提炼了乳房切除术后直接缝合的体验，强调了其可行性以及与患者对较少并发症和更快恢复的偏好的一致性。它揭示了 BREAST-Q 在充分捕捉患者细微体验方面的局限性，强调了采用更具针对性的数据收集方法的必要性。未来的研究必须完善患者报告结局测量指标（PROMs），并确保直接缝合是乳房切除术后护理中常规讨论的选项。
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