A study on patient-reported outcomes after total mastectomy and breast-conserving surgery evaluated by BREAST-Q scale_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

DU Xiaomei ¹ ,  KANG Fengying ² , HOU Jialu ¹ , SONG Qiuxiang ³ , LI Yueqin ¹ , GUO Chunrui ⁴

1. Nursing College of Shanxi Medical University, Taiyuan 030001, P. R. China;
2. Medical Training Base, The First Hospital of Shanxi Medical University, Taiyuan 030001, P. R. China;
3. Department of Galactophore, The First Hospital of Shanxi Medical University, Taiyuan 030001, P. R. China;
4. Department of Galactophore, Shanxi Provincial People’s Hospital, Taiyuan 030012, P. R. China;

Corresponding author：

KANG Fengying, Email: kkangfy@hotmail.com

Keywords：

breast cancer; patient report outcome; BREAST-Q scale; satisfaction; quality of life

DOI：

10.7507/1007-9424.202110043

Video：

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Objective To compare the differences in patient satisfaction and health-related quality of life after total mastectomy and breast-conserving surgery for breast cancer. Methods Breast cancer patients who underwent surgical treatment in the First Hospital of Shanxi Medical University and The People’s Hospital of Shanxi Province from March to June 2021 were selected as the research objects by convenient sampling method. Self-designed questionnaires were used to evaluate the general situation of the patients. Patients’ satisfaction and quality of life were investigated by using the postoperative scale of the BREAST-Q module of total mastectomy (to investigate patients after total mastectomy) and the postoperative scale of the breast-conserving plastic surgery module (to investigate patients after breast-conserving surgery), and the patient-reported outcomes of total mastectomy and breast-conserving surgery were compared, including breast satisfaction, psychosocial health, chest and upper limb physical health, sexual health, medical team satisfaction, and information satisfaction. Results In this study, there were 100 patients in the total mastectomy group and 50 patients in the breast conserving group. There were no significant differences between the two groups in marital status, monthly family income, education, body mass index, whether combined with other physical diseases, chemotherapy, targeted therapy, axillary lymph node dissection, tumor stage, and molecular typing (P>0.05). The rates of radiotherapy and endocrine therapy in the breast conserving group were higher than those in total mastectomy group ( χ²=48.701, P<0.001; χ²=15.891, P<0.001). The scores of quality of life and patient satisfaction scores of the breast conserving group including breast satisfaction, satisfactions of breast doctors, nurses and other doctors, social and mental health, sexual health score were higher than those of the total mastectomy group (P<0.001), but there was no significant difference in the physical health of chest and upper limbs score between the two groups (P>0.05). In addition, the satisfaction score of radiotherapy information in the breast conserving group was 69.40±20.44 and that of medical information given by breast surgeons was 87.04±19.46. Conclusion Scores of breast satisfaction, psychosocial health, sexual health, and health-related quality of life in breast-conserving patients are higher than those in total mastectomy patients.

1.	Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2.	Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin, 2016, 66(4): 271-289.
3.	Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med, 2002, 347(16): 1233-1241.
4.	Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med, 2002, 347(16): 1227-1232.
5.	杨青峰, 龚益平. 不同方法乳房重建术的患者报告结局. 中华普通外科学文献(电子版), 2020, 14(1): 64-67.
6.	Liu M, Wang CB, Xie F, et al. Clinical practice guidelines for diagnosis and treatment of invasive breast cancer: Chinese Society of Breast Surgery (CSBrS) practice guidelines 2021. Chin Med J (Engl), 2021, 134(9): 1009-1013.
7.	曹鋆, 吴炅. 乳腺癌患者报告结局量表BREAST-Q在乳腺外科中的应用. 中华乳腺病杂志(电子版), 2017, 11(5): 300-304.
8.	Cano SJ, Klassen AF, Scott AM, et al. The BREAST-Q: further validation in independent clinical samples. Plast Reconstr Surg, 2012, 129(2): 293-302.
9.	Pusic AL, Klassen AF, Scott AM, et al. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg, 2009, 124(2): 345-353.
10.	Aaronson N, Alonso J, Burnam A, et al. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res, 2002, 11(3): 193-205.
11.	Jain S, Boyd C, Fiorentino L, et al. Are there efficacious treatments for treating the fatigue-sleep disturbance-depression symptom cluster in breast cancer patients? A Rapid Evidence Assessment of the Literature (REAL^©). Breast Cancer (Dove Med Press), 2015, 7: 267-291.
12.	Salibasic M, Delibegovic S. The quality of life and degree of depression of patients suffering from breast cancer. Med Arch, 2018, 72(3): 202-205.
13.	Koppiker CB, Noor AU, Dixit S, et al. Extreme oncoplastic surgery for multifocal/multicentric and locally advanced breast cancer. Int J Breast Cancer, 2019, 2019: 4262589.
14.	Waljee JF, Hu ES, Ubel PA, et al. Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life. J Clin Oncol, 2008, 26(20): 3331-3337.
15.	He ZY, Tong Q, Wu SG, et al. A comparison of quality of life and satisfaction of women with early-stage breast cancer treated with breast conserving therapy vs. mastectomy in southern China. Support Care Cancer, 2012, 20(10): 2441-2449.
16.	Atisha DM, Rushing CN, Samsa GP, et al. A national snapshot of satisfaction with breast cancer procedures. Ann Surg Oncol, 2015, 22(2): 361-369.
17.	Gardfjell A, Dahlbäck C, Åhsberg K. Patient satisfaction after unilateral oncoplastic volume displacement surgery for breast cancer, evaluated with the BREAST-Q™. World J Surg Oncol, 2019, 17(1): 96.
18.	Volders JH, Negenborn VL, Haloua MH, et al. Breast-specific factors determine cosmetic outcome and patient satisfaction after breast-conserving therapy: Results from the randomized COBALT study. J Surg Oncol, 2018, 117(5): 1001-1008.
19.	Li L, Su Y, Xiu B, et al. Comparison of prepectoral and subpectoral breast reconstruction after mastectomies: a systematic review and meta analysis. Eur J Surg Oncol, 2019, 45(9): 1542-1550.
20.	Ho AY, Hu ZI, Mehrara BJ, et al. Radiotherapy in the setting of breast reconstruction: types, techniques, and timing. Lancet Oncol, 2017, 18(12): e742-e753.
21.	Nicholson RM, Leinster S, Sassoon EM. A comparison of the cosmetic and psychological outcome of breast reconstruction, breast conserving surgery and mastectomy without reconstruction. Breast, 2007, 16(4): 396-410.
22.	Veiga DF, Veiga-Filho J, Ribeiro LM, et al. Quality-of-life and self-esteem outcomes after oncoplastic breast-conserving surgery. Plast Reconstr Surg, 2010, 125(3): 811-817.

1. Sung H, Ferlay J, Siegel RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2021, 71(3): 209-249.
2. Miller KD, Siegel RL, Lin CC, et al. Cancer treatment and survivorship statistics, 2016. CA Cancer J Clin, 2016, 66(4): 271-289.
3. Fisher B, Anderson S, Bryant J, et al. Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med, 2002, 347(16): 1233-1241.
4. Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med, 2002, 347(16): 1227-1232.
5. 杨青峰, 龚益平. 不同方法乳房重建术的患者报告结局. 中华普通外科学文献(电子版), 2020, 14(1): 64-67.
6. Liu M, Wang CB, Xie F, et al. Clinical practice guidelines for diagnosis and treatment of invasive breast cancer: Chinese Society of Breast Surgery (CSBrS) practice guidelines 2021. Chin Med J (Engl), 2021, 134(9): 1009-1013.
7. 曹鋆, 吴炅. 乳腺癌患者报告结局量表BREAST-Q在乳腺外科中的应用. 中华乳腺病杂志(电子版), 2017, 11(5): 300-304.
8. Cano SJ, Klassen AF, Scott AM, et al. The BREAST-Q: further validation in independent clinical samples. Plast Reconstr Surg, 2012, 129(2): 293-302.
9. Pusic AL, Klassen AF, Scott AM, et al. Development of a new patient-reported outcome measure for breast surgery: the BREAST-Q. Plast Reconstr Surg, 2009, 124(2): 345-353.
10. Aaronson N, Alonso J, Burnam A, et al. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res, 2002, 11(3): 193-205.
11. Jain S, Boyd C, Fiorentino L, et al. Are there efficacious treatments for treating the fatigue-sleep disturbance-depression symptom cluster in breast cancer patients? A Rapid Evidence Assessment of the Literature (REAL^©). Breast Cancer (Dove Med Press), 2015, 7: 267-291.
12. Salibasic M, Delibegovic S. The quality of life and degree of depression of patients suffering from breast cancer. Med Arch, 2018, 72(3): 202-205.
13. Koppiker CB, Noor AU, Dixit S, et al. Extreme oncoplastic surgery for multifocal/multicentric and locally advanced breast cancer. Int J Breast Cancer, 2019, 2019: 4262589.
14. Waljee JF, Hu ES, Ubel PA, et al. Effect of esthetic outcome after breast-conserving surgery on psychosocial functioning and quality of life. J Clin Oncol, 2008, 26(20): 3331-3337.
15. He ZY, Tong Q, Wu SG, et al. A comparison of quality of life and satisfaction of women with early-stage breast cancer treated with breast conserving therapy vs. mastectomy in southern China. Support Care Cancer, 2012, 20(10): 2441-2449.
16. Atisha DM, Rushing CN, Samsa GP, et al. A national snapshot of satisfaction with breast cancer procedures. Ann Surg Oncol, 2015, 22(2): 361-369.
17. Gardfjell A, Dahlbäck C, Åhsberg K. Patient satisfaction after unilateral oncoplastic volume displacement surgery for breast cancer, evaluated with the BREAST-Q™. World J Surg Oncol, 2019, 17(1): 96.
18. Volders JH, Negenborn VL, Haloua MH, et al. Breast-specific factors determine cosmetic outcome and patient satisfaction after breast-conserving therapy: Results from the randomized COBALT study. J Surg Oncol, 2018, 117(5): 1001-1008.
19. Li L, Su Y, Xiu B, et al. Comparison of prepectoral and subpectoral breast reconstruction after mastectomies: a systematic review and meta analysis. Eur J Surg Oncol, 2019, 45(9): 1542-1550.
20. Ho AY, Hu ZI, Mehrara BJ, et al. Radiotherapy in the setting of breast reconstruction: types, techniques, and timing. Lancet Oncol, 2017, 18(12): e742-e753.
21. Nicholson RM, Leinster S, Sassoon EM. A comparison of the cosmetic and psychological outcome of breast reconstruction, breast conserving surgery and mastectomy without reconstruction. Breast, 2007, 16(4): 396-410.
22. Veiga DF, Veiga-Filho J, Ribeiro LM, et al. Quality-of-life and self-esteem outcomes after oncoplastic breast-conserving surgery. Plast Reconstr Surg, 2010, 125(3): 811-817.

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