Comparing Oncoplastic Breast Conserving Surgery with Mastectomy and Immediate Breast Reconstruction: Case-Matched Patient Reported Outcomes
Summary Background Oncoplastic breast conserving surgery (OBCS) allows women who may otherwise have mastectomy and immediate reconstruction (MxIR) the choice to conserve their breast yet avoid deformity. We compared the outcome of these options. Methods Two cohorts meeting study criteria were identi...
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| Veröffentlicht in: | Journal of plastic, reconstructive & aesthetic surgery reconstructive & aesthetic surgery, 2017-10, Vol.70 (10), p.1377-1385 |
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| creator | Kelsall, Jennett E., B. Med Sci, MBBS, FRACS McCulley, Stephen J., MBChB, FCS (SA) (Plast), FRCS (Plast) Brock, Lisa, BSc (Hons) (Sociology) Akerlund, Malin T.E., BSc (Psychology) Macmillan, R. Douglas, MBChB, MD, FRCS |
| description | Summary Background Oncoplastic breast conserving surgery (OBCS) allows women who may otherwise have mastectomy and immediate reconstruction (MxIR) the choice to conserve their breast yet avoid deformity. We compared the outcome of these options. Methods Two cohorts meeting study criteria were identified from prospectively audited series of women undergoing OBCS or MxIR. After case matching for age, tumour size and date of surgery, stratification by breast size, and controlling for radiotherapy; Body Image Scale (BIS) Scores of psychosocial function, and Patient Reported Outcome Measures (PROMs) for breast appearance and return to function were analysed. Results 567 women (286 treated by OBCS and 281 by MxIR) fulfilled inclusion criteria. Demographics were similar between the two unmatched cohorts, except for radiotherapy, age, and tumour size (all p < 0.001). Overall, BIS Score (p=0.002), self-rated breast appearance, return to work and function (all p |
| doi_str_mv | 10.1016/j.bjps.2017.05.009 |
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Med Sci, MBBS, FRACS ; McCulley, Stephen J., MBChB, FCS (SA) (Plast), FRCS (Plast) ; Brock, Lisa, BSc (Hons) (Sociology) ; Akerlund, Malin T.E., BSc (Psychology) ; Macmillan, R. Douglas, MBChB, MD, FRCS</creator><creatorcontrib>Kelsall, Jennett E., B. Med Sci, MBBS, FRACS ; McCulley, Stephen J., MBChB, FCS (SA) (Plast), FRCS (Plast) ; Brock, Lisa, BSc (Hons) (Sociology) ; Akerlund, Malin T.E., BSc (Psychology) ; Macmillan, R. Douglas, MBChB, MD, FRCS</creatorcontrib><description>Summary Background Oncoplastic breast conserving surgery (OBCS) allows women who may otherwise have mastectomy and immediate reconstruction (MxIR) the choice to conserve their breast yet avoid deformity. We compared the outcome of these options. Methods Two cohorts meeting study criteria were identified from prospectively audited series of women undergoing OBCS or MxIR. After case matching for age, tumour size and date of surgery, stratification by breast size, and controlling for radiotherapy; Body Image Scale (BIS) Scores of psychosocial function, and Patient Reported Outcome Measures (PROMs) for breast appearance and return to function were analysed. Results 567 women (286 treated by OBCS and 281 by MxIR) fulfilled inclusion criteria. Demographics were similar between the two unmatched cohorts, except for radiotherapy, age, and tumour size (all p < 0.001). Overall, BIS Score (p=0.002), self-rated breast appearance, return to work and function (all p<0.001) significantly favoured OBCS. Case-matched women with larger breasts treated by OBCS reported better BIS scores (mean 3.30 vs 5.37, p = 0.011) and self-rated breast appearance score (p < 0.001) compared to MxIR; whereas no significant difference was observed for smaller breasts. BIS and appearance favoured OBCS regardless of whether or not radiotherapy would have been avoided if treated by MxIR. Conclusion OBCS offers suitable women the option to avoid MxIR, whilst providing faster recovery. Better psychosocial and self-rated satisfaction with breast appearance is achieved for OBCS in all groups, regardless of the need for radiotherapy; apart from those women with smaller breasts for whom the results are comparable.</description><identifier>ISSN: 1748-6815</identifier><identifier>EISSN: 1878-0539</identifier><identifier>DOI: 10.1016/j.bjps.2017.05.009</identifier><identifier>PMID: 28712883</identifier><language>eng</language><publisher>Netherlands: Elsevier Ltd</publisher><subject>Adult ; Body Image - psychology ; Breast - pathology ; Breast Neoplasms - epidemiology ; Breast Neoplasms - pathology ; Breast Neoplasms - surgery ; Breast reconstruction ; Breast surgery ; Case-Control Studies ; Female ; Humans ; Mammaplasty - methods ; Mammaplasty - psychology ; Mastectomy - methods ; Mastectomy - psychology ; Mastectomy, Segmental - methods ; Mastectomy, Segmental - psychology ; Middle Aged ; Oncoplastic breast surgery ; Organ Size ; Patient Reported Outcome Measures ; Patient Satisfaction ; Plastic Surgery ; Quality of Life ; Radiotherapy - methods ; Recovery of Function ; Treatment Outcome ; Tumor Burden ; United Kingdom - epidemiology</subject><ispartof>Journal of plastic, reconstructive & aesthetic surgery, 2017-10, Vol.70 (10), p.1377-1385</ispartof><rights>2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons</rights><rights>Copyright © 2017 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-a4978938868d1ac85b9b4ec9edcbd6fd99d98f15937aa1d3f564078cc6e886463</citedby><cites>FETCH-LOGICAL-c411t-a4978938868d1ac85b9b4ec9edcbd6fd99d98f15937aa1d3f564078cc6e886463</cites><orcidid>0000-0002-4267-7373</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S174868151730181X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28712883$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kelsall, Jennett E., B. Med Sci, MBBS, FRACS</creatorcontrib><creatorcontrib>McCulley, Stephen J., MBChB, FCS (SA) (Plast), FRCS (Plast)</creatorcontrib><creatorcontrib>Brock, Lisa, BSc (Hons) (Sociology)</creatorcontrib><creatorcontrib>Akerlund, Malin T.E., BSc (Psychology)</creatorcontrib><creatorcontrib>Macmillan, R. Douglas, MBChB, MD, FRCS</creatorcontrib><title>Comparing Oncoplastic Breast Conserving Surgery with Mastectomy and Immediate Breast Reconstruction: Case-Matched Patient Reported Outcomes</title><title>Journal of plastic, reconstructive & aesthetic surgery</title><addtitle>J Plast Reconstr Aesthet Surg</addtitle><description>Summary Background Oncoplastic breast conserving surgery (OBCS) allows women who may otherwise have mastectomy and immediate reconstruction (MxIR) the choice to conserve their breast yet avoid deformity. We compared the outcome of these options. Methods Two cohorts meeting study criteria were identified from prospectively audited series of women undergoing OBCS or MxIR. After case matching for age, tumour size and date of surgery, stratification by breast size, and controlling for radiotherapy; Body Image Scale (BIS) Scores of psychosocial function, and Patient Reported Outcome Measures (PROMs) for breast appearance and return to function were analysed. Results 567 women (286 treated by OBCS and 281 by MxIR) fulfilled inclusion criteria. Demographics were similar between the two unmatched cohorts, except for radiotherapy, age, and tumour size (all p < 0.001). Overall, BIS Score (p=0.002), self-rated breast appearance, return to work and function (all p<0.001) significantly favoured OBCS. Case-matched women with larger breasts treated by OBCS reported better BIS scores (mean 3.30 vs 5.37, p = 0.011) and self-rated breast appearance score (p < 0.001) compared to MxIR; whereas no significant difference was observed for smaller breasts. BIS and appearance favoured OBCS regardless of whether or not radiotherapy would have been avoided if treated by MxIR. Conclusion OBCS offers suitable women the option to avoid MxIR, whilst providing faster recovery. Better psychosocial and self-rated satisfaction with breast appearance is achieved for OBCS in all groups, regardless of the need for radiotherapy; apart from those women with smaller breasts for whom the results are comparable.</description><subject>Adult</subject><subject>Body Image - psychology</subject><subject>Breast - pathology</subject><subject>Breast Neoplasms - epidemiology</subject><subject>Breast Neoplasms - pathology</subject><subject>Breast Neoplasms - surgery</subject><subject>Breast reconstruction</subject><subject>Breast surgery</subject><subject>Case-Control Studies</subject><subject>Female</subject><subject>Humans</subject><subject>Mammaplasty - methods</subject><subject>Mammaplasty - psychology</subject><subject>Mastectomy - methods</subject><subject>Mastectomy - psychology</subject><subject>Mastectomy, Segmental - methods</subject><subject>Mastectomy, Segmental - psychology</subject><subject>Middle Aged</subject><subject>Oncoplastic breast surgery</subject><subject>Organ Size</subject><subject>Patient Reported Outcome Measures</subject><subject>Patient Satisfaction</subject><subject>Plastic Surgery</subject><subject>Quality of Life</subject><subject>Radiotherapy - methods</subject><subject>Recovery of Function</subject><subject>Treatment Outcome</subject><subject>Tumor Burden</subject><subject>United Kingdom - epidemiology</subject><issn>1748-6815</issn><issn>1878-0539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9ks1u1TAQhSMEoqXwAixQlmwS7Dg_NkJIJaJQqdVFFCR2ljOetA5JHGyn1X0GXhpHt2XBgpVHnnNGmu9MkrykJKeE1m-GvBsWnxeENjmpckLEo-SY8oZnpGLicaybkmc1p9VR8sz7gZCS0bJ6mhwVvKEF5-w4-d3aaVHOzNfpbga7jMoHA-kHh7FIWzt7dLdb92p11-j26Z0JN-llbCIEO-1TNev0fJpQGxXwwfcVITqDWyEYO79NW-Uxu1QBblCnX1QwOG-ixboQP3ZrADuhf5486dXo8cX9e5J8P_v4rf2cXew-nbenFxmUlIZMlaLhgnFec00V8KoTXYkgUEOn614LoQXvaSVYoxTVrK_qkjQcoMboKWt2krw-zF2c_bWiD3IyHnAc1Yx29ZKKiFTUrBRRWhyk4Kz3Dnu5ODMpt5eUyC0EOcgtBLmFIEklYwjR9Op-_tpFMH8tD9Sj4N1BgHHLW4NOeohIIEJ0EavU1vx__vt_7DCa2YAaf-Ie_WBXN0d-kkpfSCKvtjPYroA2jFBOf7A_bvKwcw</recordid><startdate>20171001</startdate><enddate>20171001</enddate><creator>Kelsall, Jennett E., B. Med Sci, MBBS, FRACS</creator><creator>McCulley, Stephen J., MBChB, FCS (SA) (Plast), FRCS (Plast)</creator><creator>Brock, Lisa, BSc (Hons) (Sociology)</creator><creator>Akerlund, Malin T.E., BSc (Psychology)</creator><creator>Macmillan, R. Douglas, MBChB, MD, FRCS</creator><general>Elsevier Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4267-7373</orcidid></search><sort><creationdate>20171001</creationdate><title>Comparing Oncoplastic Breast Conserving Surgery with Mastectomy and Immediate Breast Reconstruction: Case-Matched Patient Reported Outcomes</title><author>Kelsall, Jennett E., B. Med Sci, MBBS, FRACS ; McCulley, Stephen J., MBChB, FCS (SA) (Plast), FRCS (Plast) ; Brock, Lisa, BSc (Hons) (Sociology) ; Akerlund, Malin T.E., BSc (Psychology) ; Macmillan, R. Douglas, MBChB, MD, FRCS</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-a4978938868d1ac85b9b4ec9edcbd6fd99d98f15937aa1d3f564078cc6e886463</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Body Image - psychology</topic><topic>Breast - pathology</topic><topic>Breast Neoplasms - epidemiology</topic><topic>Breast Neoplasms - pathology</topic><topic>Breast Neoplasms - surgery</topic><topic>Breast reconstruction</topic><topic>Breast surgery</topic><topic>Case-Control Studies</topic><topic>Female</topic><topic>Humans</topic><topic>Mammaplasty - methods</topic><topic>Mammaplasty - psychology</topic><topic>Mastectomy - methods</topic><topic>Mastectomy - psychology</topic><topic>Mastectomy, Segmental - methods</topic><topic>Mastectomy, Segmental - psychology</topic><topic>Middle Aged</topic><topic>Oncoplastic breast surgery</topic><topic>Organ Size</topic><topic>Patient Reported Outcome Measures</topic><topic>Patient Satisfaction</topic><topic>Plastic Surgery</topic><topic>Quality of Life</topic><topic>Radiotherapy - methods</topic><topic>Recovery of Function</topic><topic>Treatment Outcome</topic><topic>Tumor Burden</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kelsall, Jennett E., B. Med Sci, MBBS, FRACS</creatorcontrib><creatorcontrib>McCulley, Stephen J., MBChB, FCS (SA) (Plast), FRCS (Plast)</creatorcontrib><creatorcontrib>Brock, Lisa, BSc (Hons) (Sociology)</creatorcontrib><creatorcontrib>Akerlund, Malin T.E., BSc (Psychology)</creatorcontrib><creatorcontrib>Macmillan, R. Douglas, MBChB, MD, FRCS</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kelsall, Jennett E., B. Med Sci, MBBS, FRACS</au><au>McCulley, Stephen J., MBChB, FCS (SA) (Plast), FRCS (Plast)</au><au>Brock, Lisa, BSc (Hons) (Sociology)</au><au>Akerlund, Malin T.E., BSc (Psychology)</au><au>Macmillan, R. Douglas, MBChB, MD, FRCS</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparing Oncoplastic Breast Conserving Surgery with Mastectomy and Immediate Breast Reconstruction: Case-Matched Patient Reported Outcomes</atitle><jtitle>Journal of plastic, reconstructive & aesthetic surgery</jtitle><addtitle>J Plast Reconstr Aesthet Surg</addtitle><date>2017-10-01</date><risdate>2017</risdate><volume>70</volume><issue>10</issue><spage>1377</spage><epage>1385</epage><pages>1377-1385</pages><issn>1748-6815</issn><eissn>1878-0539</eissn><abstract>Summary Background Oncoplastic breast conserving surgery (OBCS) allows women who may otherwise have mastectomy and immediate reconstruction (MxIR) the choice to conserve their breast yet avoid deformity. We compared the outcome of these options. Methods Two cohorts meeting study criteria were identified from prospectively audited series of women undergoing OBCS or MxIR. After case matching for age, tumour size and date of surgery, stratification by breast size, and controlling for radiotherapy; Body Image Scale (BIS) Scores of psychosocial function, and Patient Reported Outcome Measures (PROMs) for breast appearance and return to function were analysed. Results 567 women (286 treated by OBCS and 281 by MxIR) fulfilled inclusion criteria. Demographics were similar between the two unmatched cohorts, except for radiotherapy, age, and tumour size (all p < 0.001). Overall, BIS Score (p=0.002), self-rated breast appearance, return to work and function (all p<0.001) significantly favoured OBCS. Case-matched women with larger breasts treated by OBCS reported better BIS scores (mean 3.30 vs 5.37, p = 0.011) and self-rated breast appearance score (p < 0.001) compared to MxIR; whereas no significant difference was observed for smaller breasts. BIS and appearance favoured OBCS regardless of whether or not radiotherapy would have been avoided if treated by MxIR. Conclusion OBCS offers suitable women the option to avoid MxIR, whilst providing faster recovery. Better psychosocial and self-rated satisfaction with breast appearance is achieved for OBCS in all groups, regardless of the need for radiotherapy; apart from those women with smaller breasts for whom the results are comparable.</abstract><cop>Netherlands</cop><pub>Elsevier Ltd</pub><pmid>28712883</pmid><doi>10.1016/j.bjps.2017.05.009</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4267-7373</orcidid></addata></record> |
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| subjects | Adult Body Image - psychology Breast - pathology Breast Neoplasms - epidemiology Breast Neoplasms - pathology Breast Neoplasms - surgery Breast reconstruction Breast surgery Case-Control Studies Female Humans Mammaplasty - methods Mammaplasty - psychology Mastectomy - methods Mastectomy - psychology Mastectomy, Segmental - methods Mastectomy, Segmental - psychology Middle Aged Oncoplastic breast surgery Organ Size Patient Reported Outcome Measures Patient Satisfaction Plastic Surgery Quality of Life Radiotherapy - methods Recovery of Function Treatment Outcome Tumor Burden United Kingdom - epidemiology |
| title | Comparing Oncoplastic Breast Conserving Surgery with Mastectomy and Immediate Breast Reconstruction: Case-Matched Patient Reported Outcomes |
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