A comparison of patient satisfaction (using the BREAST-Q questionnaire) with bilateral breast reconstruction following risk-reducing or therapeutic mastectomy

被引:20
作者
Kazzazi, F. [1 ]
Haggie, R. [1 ]
Forouhi, P. [2 ]
Kazzazi, N. [3 ]
Wyld, L. [3 ,5 ]
Malata, C. M. [2 ,4 ,6 ,7 ]
机构
[1] Univ Cambridge, Sch Clin Med, Cambridge, Cambs, England
[2] Cambridge Univ Hosp NHS Fdn Trust, Addenbrookes Hosp, Cambridge Breast Unit, Cambridge, Cambs, England
[3] Doncaster Royal Infirm, Jasmine Breast Ctr, Doncaster, S Yorkshire, England
[4] Cambridge Univ Hosp NHS Fdn Trust, Addenbrookes Hosp, Dept Plast & Reconstruct Surg, Box 186,Hills Rd, Cambridge CB2 2QQ, Cambs, England
[5] Univ Sheffield, Sheffield, S Yorkshire, England
[6] Anglia Ruskin Univ, Sch Med, Chelmsford, Essex, England
[7] Anglia Ruskin Univ, Sch Med, Cambridge, Cambs, England
关键词
Breast Surgery; Patient reported outcome measures; Breast-q; Mastectomy; Risk-reducing; Satisfaction; QUALITY-OF-LIFE; MUTATION CARRIERS; IMPACT;
D O I
10.1016/j.bjps.2018.06.011
中图分类号
R61 [外科手术学];
学科分类号
摘要
Introduction: Patients undergoing mastectomy and immediate breast reconstruction for cancer may be expected to have different perceptions of long-term outcomes compared with those who have this operation prophylactically. Methods: Patients who underwent bilateral mastectomy and breast reconstruction from 2008 to 2014 at the Cambridge Breast Unit were identified from a prospective register and their notes were audited. They were classified according to their indication for surgery as follows: bilaterally therapeutic, bilaterally risk-reducing or combination. The BREAST-Q (TM) questionnaire was posted to participants using the 'total Dittman method'. Q-SCORE software was utilised to analyse patient satisfaction scores. Results: Sixty-five (58%) responses were received, of which 8 were excluded, leaving 57 usable for the study. The therapeutic group had higher patient satisfaction than the risk-reducing group across most domains including breast, outcome, psychosocial, sexual, physical and information. The combination group scored lower and BRCA gene mutation-positive patients scored the lowest. Physical well-being was maintained across all groups but psychosocial/sexual well-being varied. Good psychosocial well-being was linked to a higher satisfaction with the outcome in the combination and risk-reducing groups. Conclusion: This study highlights the need for clinicians to take into account the indication for surgery as a major psychological factor in patients' perception of self and experience of surgery. It demonstrates that bilateral immediate reconstruction patients report similar physical symptoms irrespective of indication for mastectomy, but the decision-making process in terms of risk-balancing and diagnosis influences satisfaction with self and surgery. It underlines the importance of preoperative management of expectations for patients undergoing risk-reducing procedures. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
引用
收藏
页码:1324 / 1331
页数:8
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