Sowa Yoshihiro, Seki Hirohito, Abe Hiroyasu, Komiya Takako, Kato Maho, Takano Junji, Yoshimura Kotaro, Saiga Miho
Department of Plastic Surgery, Jichi Medical University, Yakushiji, Shimotsuke, Tochigi, 3311-1329-0498, Japan.
Department of Breast Surgery, Kyorin University School of Medicine, Tokyo, Japan.
Breast Cancer. 2025 May 4. doi: 10.1007/s12282-025-01709-3.
In recent years, the age range of patients undergoing breast reconstruction has expanded. Establishment of the influence of the age of a patient with breast cancer on the level of regret after breast reconstruction could assist in decision-making across age groups at the time of choice of options for breast cancer surgery.
The objective of the study is to investigate the current age distribution of patients undergoing treatment for breast cancer in Japan through a multicenter collaborative study, and to examine the impact of age on post-surgical decision regret, analyzed by type of surgical procedure.
A multicenter observational retrospective study was conducted in 576 patients who were diagnosed with breast cancer pathologically and underwent mastectomy (Bt), breast-conserving surgery (Bc) or breast reconstruction (Br). Demographic and outcome data were collected and the level of regret concerning the surgical decision was surveyed using the Decision Regret Scale (DRS) across the different patient groups.
The average age of the Bt group was significantly higher than those in the Bc and Br groups. The level of regret was slightly but significantly higher in the Br group compared to the other groups. Regression analysis of the relationship between age and DRS scores indicated that reconstruction is associated with an increase of about 5 points in the DRS score. This analysis also revealed that the DRS score slightly increases with advancing age, regardless of the surgical method.
In reconstruction cases, addition of new surgical procedures may lead to more complications, which might have slightly increased regret; however, the increase was not significant. Thus, although more cautious surgical criteria are desirable for older patients, age alone should not be a deterrent to opting for breast reconstruction.
近年来，接受乳房重建手术的患者年龄范围有所扩大。确定乳腺癌患者年龄对乳房重建术后遗憾程度的影响，有助于在乳腺癌手术选择方案时，为各年龄组的决策提供帮助。
本研究的目的是通过一项多中心合作研究，调查日本乳腺癌治疗患者的当前年龄分布，并按手术方式分析年龄对术后决策遗憾的影响。
对576例经病理诊断为乳腺癌并接受乳房切除术（Bt）、保乳手术（Bc）或乳房重建术（Br）的患者进行了一项多中心观察性回顾性研究。收集了人口统计学和结果数据，并使用决策遗憾量表（DRS）对不同患者组手术决策的遗憾程度进行了调查。
Bt组的平均年龄显著高于Bc组和Br组。Br组的遗憾程度略高于其他组，但差异显著。年龄与DRS评分关系的回归分析表明，重建手术使DRS评分增加约5分。该分析还显示，无论手术方式如何，DRS评分都随年龄增长略有增加。
在重建病例中，增加新的手术方式可能会导致更多并发症，这可能会使遗憾程度略有增加；然而，增加并不显著。因此，尽管老年患者需要更谨慎的手术标准，但年龄本身不应成为选择乳房重建的阻碍。
