Selvarajoo Ghaithiry, See Mee Hoong, Lee Lai Lee, Ng Jing Hui, Mosiun Joanne Aisha, Sikin Seniyah Md, Baghawi Anita
Department of Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
Breast and Endocrine Surgery Unit, Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
World J Surg. 2025 Aug 22. doi: 10.1002/wjs.70045.
Breast cancer remains the most frequently diagnosed cancer among women globally, including Malaysia. Patient reported outcomes (PROs) such as satisfaction and quality of life (QOL) have become crucial in evaluating the effectiveness of breast surgery, especially as survival rates improve. The BREAST-Q, a validated PRO measure, was developed to assess these factors from the patient perspective. This study aims to evaluate and compare the QOL and satisfaction outcomes between mastectomy and breast-conserving surgery (BCS) among Malaysian breast cancer patients.
This multi-center, prospective cohort study included 230 women with stage 0 to III breast cancer undergoing mastectomy or BCS from January 2022 to April 2023. This study was conducted at Universiti Malaya Medical Center, Hospital Putrajaya, and Hospital Sultan Ismail Johor Bahru. The BREAST-Q questionnaire was administered preoperatively, and at 6 and 12 months postoperatively. Data were analyzed using descriptive statistics, independent t-tests, and ANOVA for multivariate analysis.
Out of 230 patients, 49.6% had mastectomies, and 50.4% had BCS. BCS patients reported significantly higher satisfaction and QOL across domains, particularly in psychosocial and sexual well-being at all postoperative time points. Physical well-being favored the BCS group only at the 12-month mark. Satisfaction with the surgeon and medical team was notably higher in the mastectomy group.
BCS was associated with higher patient satisfaction and QOL than mastectomy, suggesting it as a beneficial surgical option. The BREAST-Q tool provides a valuable framework to aid patient-surgeon discussions, improve patient preparedness, and inform surgical decision-making.
乳腺癌仍然是全球女性中最常被诊断出的癌症，马来西亚也不例外。患者报告的结果（PROs），如满意度和生活质量（QOL），在评估乳房手术的有效性方面变得至关重要，尤其是随着生存率的提高。BREAST-Q是一种经过验证的PRO测量工具，旨在从患者角度评估这些因素。本研究旨在评估和比较马来西亚乳腺癌患者乳房切除术和保乳手术（BCS）之间的生活质量和满意度结果。
这项多中心前瞻性队列研究纳入了230名0至III期乳腺癌女性患者，她们在2022年1月至2023年4月期间接受了乳房切除术或BCS。该研究在马来亚大学医学中心、布城医院和柔佛州新山市苏丹伊斯梅尔医院进行。术前、术后6个月和12个月时发放BREAST-Q问卷。使用描述性统计、独立t检验和方差分析进行多变量分析。
在230名患者中，49.6%接受了乳房切除术，50.4%接受了BCS。BCS患者在各个领域的满意度和生活质量报告均显著更高，尤其是在所有术后时间点的心理社会和性健康方面。身体状况仅在术后12个月时有利于BCS组。乳房切除术组对外科医生和医疗团队的满意度明显更高。
与乳房切除术相比，BCS与更高的患者满意度和生活质量相关，表明它是一种有益的手术选择。BREAST-Q工具提供了一个有价值的框架，有助于患者与外科医生的讨论，提高患者的准备程度，并为手术决策提供信息。
