Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Sample Size Calculation
2.2. Measuring
Health Questionnaire SF-36 and SF-6D
2.3. Statistical Methods
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Siegel, R.L.; Miller, K.D.; Jemal, A. Cancer statistics, 2017. CA Cancer J. Clin. 2017, 67, 7–30. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Jemal, A.; Bray, F.; Center, M.M.; Ferlay, J.; Ward, E.; Forman, D. Global cancer statistics. CA Cancer J. Clin. 2011, 61, 69–90. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Croatian Institute of Public Health. Croatian National Cancer Registry. Cancer Incidence in Croatia 2014. 2016. Available online: https://public-health.hr/ (accessed on 10 December 2021).
- Pačarić, S.; Orkić, Ž.; Erić, I.; Turk, T.; Kondža, G.; Farčić, N.; Marta Biljan, M.; Gvozdanović, Z.; Milostić-Srb, A.; Barać, I.; et al. Assesment of emotional functioning and self-perception in post mastectomy women. Psychiatr. Danub. 2021; in press. [Google Scholar] [CrossRef]
- Prates, A.C.L.; Freitas-Junior, R.; Prates, M.F.O.; Veloso, M.F.; Barros, N.M. Influence of body image in women undergoing treatment for breast cancer. Rev. Bras. Ginecol. Obstet. 2017, 39, 175–183. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Okamura, H.; Watanabe, T.; Narabayashi, M.; Katsumata, N.; Ando, M.; Adachi, I.; Akechi, T.; Uchitomi, Y. Psychological distress following first recurrence of disease in patients with breast cancer: Prevalence and risk factors. Breast Cancer Res. Treat. 2000, 61, 131–137. [Google Scholar] [CrossRef] [PubMed]
- Rozen, W.M.; Ashton, M.W.; Taylor, G.I. Defining the role for autologous breast reconstruction after mastectomy: Social and oncologic implications. Clin. Breast Cancer. 2008, 8, 134–142. [Google Scholar] [CrossRef]
- Milas, I.; Zore, Z.; Roth, A.; Orešić, T.; Eljuga, D.; Gulan, M.; Guteša, I.; Stanec, M. Breast reconstruction. Libr. Oncol. 2014, 42, 29–35. Available online: https://hrcak.srce.hr/199015 (accessed on 10 December 2021).
- Schmauss, D.; Machens, H.G.; Harder, Y. Breast reconstruction after mastectomy. Front. Surg. 2016, 2, 71. [Google Scholar] [CrossRef]
- Djohan, R.; Gage, E.; Bernard, S. Breast reconstruction options following mastectomy. Cleve Clin. J. Med. 2008, 75, S17–S23. [Google Scholar] [CrossRef] [Green Version]
- Politi, M.C.; Wolin, K.Y.; Légaré, F. Implementing clinical practice guidelines about health promotion and disease prevention through shared decision making. J. Gen. Intern. Med. 2013, 28, 838–844. [Google Scholar] [CrossRef] [Green Version]
- Rezai, M.; Darsow, M.; Kummel, S.; Kramer, S. Autologous and alloplastic breast reconstruction--overview of techniques, indications and results. Gynakol. Geburtshilfliche Rundsch. 2008, 48, 68–75. [Google Scholar] [CrossRef] [PubMed]
- Joslyn, S.A. Patterns of care for immediate and early delayed breast reconstruction following mastectomy. Plast. Reconstr. Surg. 2005, 115, 1289–1296. [Google Scholar] [CrossRef] [PubMed]
- Göktaş, S.B.; Güllüoğlu, B.M.; Şelimen, D. Immediate or delayed breast reconstruction after radical mastectomy in breast cancer patients: Does it make a difference in the quality of life. Turk. Klin. Tip Bilimleri Derg. 2011, 31, 664–673. [Google Scholar] [CrossRef] [Green Version]
- Neyt, M.J.; Blondeel, P.N.; Morrison, C.M.; Albrecht, J.A. Comparing the cost of delayed and immediate autologous breast reconstruction in Belgium. Br. J. Plast. Surg. 2005, 58, 493–497. [Google Scholar] [CrossRef]
- Reavey, P.; McCarthy, C.M. Update on breast reconstruction in breast cancer. Curr. Opin. Obstet. Gynecol. 2008, 20, 61–67. [Google Scholar] [CrossRef]
- Tanos, G.; Prousskaia, E.; Chow, W.; Angelaki, A.; Cirwan, C.; Hamed, H.; Farhadi, J. Locally advanced breast cancer: Autologous versus implant-based reconstruction. Plast. Reconstr. Surg. Glob. Open. 2016, 4, e622. [Google Scholar] [CrossRef]
- Ananthakrishnan, P.; Lucas, A. Options and considerations in the timing of breast reconstruction after mastectomy. Clevel. Clin. J. Med. 2008, 75, S30–S33. [Google Scholar] [CrossRef] [PubMed]
- Winters, Z.E.; Benson, J.R.; Pusic, A.L. A systematic review of the clinical evidence to guide treatment recommendations in breast reconstruction based on patient- reported outcome measures and health-related quality of life. Ann. Surg. 2010, 252, 929–942. [Google Scholar] [CrossRef]
- Donovan, K.; Sanson-Fisher, R.W.; Redman, S. Measuring quality of life in cancer patients. J. Clin. Oncol. 1989, 7, 959–968. [Google Scholar] [CrossRef]
- Eltahir, Y.; Werners, L.L.C.H.; Dreise, M.M.; van Emmichoven, I.A.Z.; Jansen, L.; Werker, P.M.N.; de Bock, G.H. Quality-of-life outcomes between mastectomy alone and breast reconstruction: Comparison of patient-reported BREAST-Q and other health-related quality-of-life measures. Plast. Reconstr. Surg. 2013, 132, 201e–209e. [Google Scholar] [CrossRef]
- Zhong, T.; McCarthy, C.; Min, S.; Zhang, J.; Beber, B.; Pusic, A.L.; Hofer, S.O. Patient satisfaction and health-related quality of life after autologous tissue breast reconstruction: A prospective analysis of early postoperative outcomes. Cancer 2012, 118, 1701–1709. [Google Scholar] [CrossRef] [PubMed]
- Shea-Budgell, M.; Quan, M.L.; Mehling, B.; Temple-Oberle, C. Breast reconstruction following prophylactic or therapeutic mastectomy for breast cancer: Recommendations from an evidence-based provincial guideline. Plast. Surg. 2014, 22, 103–111. [Google Scholar] [CrossRef] [Green Version]
- Platt, J.; Baxter, N.; Zhong, T. Breast reconstruction after mastectomy for breast cancer. CMAJ 2011, 183, 2109–2116. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Pačarić, S.; Kristek, J.; Mirat, J.; Kondža, G.; Turk, T.; Farčić, N.; Orkić, Ž.; Nemčić, A. The quality of life of Croatian women after mastectomy: A cross-sectional single-center study. BMC Public Health 2018, 18, 999. [Google Scholar] [CrossRef]
- Vlajcic, Z.; Martic, K.; Budi, S.; Roje, Z.; Dewing, D.; Zic, R. The “dermal cage”: Inferiorly based dermal flap technique for breast reconstruction after mastectomy. J. Plast. Reconstr. Aesthet. Surg. 2020, 73, 486–493. [Google Scholar] [CrossRef]
- Roje, Z.; Roje, Ž.; Janković, S.; Ninković, M. Breast reconstruction after mastectomy. Coll. Antropol. 2010, 34, 113–123. Available online: https://hrcak.srce.hr/51737 (accessed on 10 December 2021).
- Ware, J.E., Jr.; Sherbourne, C.D. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med. Care 1992, 30, 473–483. [Google Scholar] [CrossRef]
- Treanor, C.; Donnelly, M. A methodological review of the Short Form Health Survey 36 (SF-36) and its derivatives among breast cancer survivors. Qual. Life Res. 2015, 24, 339–362. [Google Scholar] [CrossRef]
- Ware, J.E.; Snow, K.; Kosinski, M.; Gandek, B. SF-36 Health Survey: Manual and Interpretation Guide; The Health Institute, New England Medical Center: Boston, MA, USA, 2000. [Google Scholar]
- Maslić Seršić, D.; Vuletić, G. Psychometric evaluation and establishing norms of croatian sf-36 Health Survey: Framework for subjective health research. Croat. Med. J. 2006, 47, 95–102. [Google Scholar]
- Pačarić, S.; Turk, T.; Orkić, Ž.; Farčić, N.; Erić, I.; Nemčić, A. The impact of demographic factors on quality of life in women after breast cancer surgery. Niger. J. Clin. Pract. 2021, 24, 51–58. [Google Scholar] [CrossRef] [PubMed]
- Poder, G.T.; Fauteux, V.; He, J.; Brazier, J.E. Consistency between three different ways of administering the short form 6-dimension version 2. Value Health 2019, 22, 837–842. [Google Scholar] [CrossRef] [PubMed]
- Brazier, J.E.; Mulhern, B.J.; Bjorner, J.B.; Gandek, B.; Rowen, D.; Alonso, J.; Vilagut, G.; Ware, J.E.; SF-6Dv2 International Project Group. Developing a New Version of the SF-6D Health State Classification System From the SF-36v2: SF-6Dv2. Med. Care 2020, 58, 557–565. [Google Scholar] [CrossRef] [PubMed]
- Whitehead, S.J.; Ali, S. Health outcomes in economic evaluation: The QALY and utilities. Br. Med. Bull. 2010, 96, 5–21. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- MedCalc Software Ltd., Ostend, Belgium. 2020. Available online: https://www.medcalc.org (accessed on 10 May 2021).
- Sun, Y.; Kim, S.W.; Heo, C.Y.; Kim, D.; Hwang, Y.; Yom, C.K.; Kang, E. Comparison of quality of life based on surgical technique in patients with breast cancer. JPN J. Clin. Oncol. 2014, 44, 22–27. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Siqueira, H.F.F.; Teixeira, J.L.A.; Lessa Filho, R.D.S.; Hora, E.C.; Brasileiro, F.F.; Borges, K.S.; Brito, É.A.C.; Lima, M.S.; Marques, A.D.; Moura, A.R.; et al. Patient satisfaction and quality of life in breast reconstruction: Assessment of outcomes of immediate, delayed, and nonreconstruction. BMC Res. Notes 2020, 13, 223. [Google Scholar] [CrossRef] [Green Version]
- Dauplat, J.; Kwiatkowski, F.; Rouanet, P.; Delay, E.; Clough, K.; Verhaeghe, J.L.; Raoust, I.; Houvenaeghel, G.; Lemasurier, P.; Thivat, E.; et al. Quality of life after mastectomy with or without immediate breast reconstruction. Br. J. Surg. 2017, 104, 1197–1206. [Google Scholar] [CrossRef]
- Tiezzi, M.F.; de Andrade, J.M.; Romão, A.P.; Tiezzi, D.G.; Lerri, M.R.; Carrara, H.A.; Lara, L.A. Quality of life in women with breast cancer treated with or without chemotherapy. Cancer Nurs. 2017, 40, 108–116. [Google Scholar] [CrossRef]
- Abu Farha, N.H.; Khatib, M.T.; Salameh, H.; Zyoud, S.H. Cancer-related post-treatment pain and its impact on health-related quality of life in breast cancer patients: A cross sectional study in Palestine. Asia Pac. Fam. Med. 2017, 16, 7. [Google Scholar] [CrossRef] [Green Version]
- Kuliński, W.; Kosno, M. quality of life in women after mastectomy. Clinical and social study. Wiad. Lek. 2021, 74, 429–435. [Google Scholar] [CrossRef]
- Gass, J.; Mitchell, S.; Hanna, M. How do breast cancer surgery scars impact survivorship? Findings from a nationwide survey in the United States. BMC Cancer 2019, 19, 342. [Google Scholar] [CrossRef]
- Husić, S.; Brkljačić Žagrović, M. Quality of life disorder after mastectomy for breast cancer and the body image changes. Med. Flum. 2010, 46, 80–85. Available online: https://hrcak.srce.hr/48842 (accessed on 10 December 2021).
- Toriy, M.A.; Krawulski, E.; de Souza Brasiliense Viera, J.; da Luz, M.C.; Sperandio, F.F. Perceptions, feelings and physical and emotional experiences of woman after breast cancer. J. Hum. Grow Dev. 2013, 23, 303–308. [Google Scholar] [CrossRef] [Green Version]
- Heidari, M.; Shahbazi, S.; Ghodusi, M. Evaluation of body esteem and mental health in patients with breast cancer after mastectomy. J. Midlife Health 2015, 6, 173–177. [Google Scholar] [CrossRef] [PubMed]
- Engel, J.; Kerr, J.; Schlesinger-Raab, A.; Sauer, H.; Hölzel, D. Quality of life following breast-conserving therapy or mastectomy: Results of a 5-year prospective study. Breast J. 2004, 10, 223–231. [Google Scholar] [CrossRef] [PubMed]
- Kroenke, C.H.; Fung, T.T.; Hu, F.B.; Holmes, M.D. Dietary patterns and survival after breast cancer diagnosis. J. Clin. Oncol. 2005, 23, 9295–9303. [Google Scholar] [CrossRef] [PubMed]
- Adam, A.; Koranteng, F. Availability, accessibility, and impact of social support on breast cancer treatment among breast cancer patients in Kumasi, Ghana: A qualitative study. PLoS ONE 2020, 15, e0231691. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Shekhawat, L.; Busheri, L.; Dixit, S.; Patel, C.; Dhar, U.; Koppiker, C. Patient-reported outcomes following breast reconstruction surgery and therapeutic mammoplasty: Prospective evaluation 1-year post-surgery with BREAST-Q questionnaire. Indian J. Surg. Oncol. 2015, 6, 356–362. [Google Scholar] [CrossRef] [Green Version]
- Elder, E.E.; Brandberg, Y.; Björklund, T.; Rylander, R.; Lagergren, J.; Jurell, G.; Wickman, M.; Sandelin, K. Quality of life and patient satisfaction in breast cancer patients after immediate breast reconstruction: A prospective study. Breast 2005, 14, 201–208. [Google Scholar] [CrossRef]
- Alkaff, T.M.; AlTaleb, R.M.; Kattan, A.E.; Alsaif, H.K.; Murshid, R.E.; AlShaibani, T.J. Awareness, acceptance, and perspective of women for reconstruction post mastectomy. J. Pak. Med. Assoc. 2019, 69, 141–145. [Google Scholar]
- Saied, S.M.; EL-Sherbiny, A.M. Acceptability of breast reconstruction after mastectomy in Upper Egypt. Egypt. J. Plast. Reconstr. Surg. 2006, 30, 1. [Google Scholar]
- Fallbjörk, U.; Karlsson, S.; Salander, P.; Rasmussen, B.H. Differences between women who have and have not undergone breast reconstruction after mastectomy due to breast cancer. Acta Oncol. 2010, 49, 174–179. [Google Scholar] [CrossRef] [PubMed]
- Ananian, P.; Houvenaeghel, G.; Protière, C.; Rouanet, P.; Arnaud, S.; Moatti, J.P.; Tallet, A.; Braud, A.C.; Julian-Reynier, C. Determinants of patients’ choice of reconstruction with mastectomy for primary breast cancer. Ann. Surg. Oncol. 2004, 11, 762–771. [Google Scholar] [CrossRef] [PubMed]
- Wilkins, E.G.; Hamill, J.B.; Kim, H.M.; Kim, J.Y.; Greco, R.J.; Qi, J.; Pusic, A.L. Complications in postmastectomy breast reconstruction: One-year outcomes of the mastectomy reconstruction outcomes consortium (MROC) Study. Ann. Surg. 2018, 267, 164–170. [Google Scholar] [CrossRef] [PubMed] [Green Version]
- Zhong, T.; Hu, J.; Bagher, S.; Vo, A.; O’Neill, A.C.; Butler, K.; Novak, C.B.; Hofer, S.O.P.; Metcalfe, K.A. A comparison of psychological response, body image, sexuality, and quality of life between immediate and delayed autologous tissue breast reconstruction: A prospective long-term outcome study. Plast. Reconstr. Surg. 2016, 138, 772–780. [Google Scholar] [CrossRef] [PubMed]
- Othman, D.; Khan, A.; Riaz, M. Immediate, versus delayed post mastectomy breast reconstruction. PMFA J. 2019, 6, 1–3. Available online: https://www.thepmfajournal.com/features/post/immediate-versus-delayed-post-mastectomy-breast-reconstruction (accessed on 11 March 2021).
- Yoon, A.P.; Qi, J.; Brown, D.L.; Kim, H.M.; Hamill, J.B.; Erdmann-Sager, J.; Pusic, A.L.; Wilkins, E.G. Outcomes of immediate versus delayed breast reconstruction: Results of a multicenter prospective study. Breast 2018, 37, 72–79. [Google Scholar] [CrossRef] [Green Version]
- Razdan, S.N.; Cordeiro, P.G.; Albornoz, C.R.; Ro, T.; Cohen, W.A.; Mehrara, B.J.; McCarthy, C.M.; Disa, J.J.; Pusic, A.L.; Matros, E. Cost-effectiveness analysis of breast reconstruction options in the setting of postmastectomy radiotherapy using the BREAST-Q. Plast. Reconstr. Surg. 2016, 137, 510e–517e. [Google Scholar] [CrossRef] [Green Version]
- Rautalin, M.; Jahkola, T.; Roine, R.P. Breast reconstruction–prospective follow up on breast cancer patients’ health-related quality of life. World J. Surg. 2022, 46, 836–844. [Google Scholar] [CrossRef]
- Kovačević, P.; Miljković, S.; Višnjić, A.; Kozarski, J.; Janković, R. Quality of life indicators in patients operated on for breast cancer in relation to the type of surgery-a retrospective cohort study of women in Serbia. Medicina 2020, 56, 402. [Google Scholar] [CrossRef]
- Wang, F.; Koltz, P.F.; Sbitany, H. Lessons learned from the American College of Surgeons National Surgical Quality Improvement Program Database: Has centralized data collection improved immediate breast reconstruction outcomes and safety? Plast. Reconstr. Surg. 2014, 134, 859–868. [Google Scholar] [CrossRef]
- Vrdoljak, E.; Balja, M.P.; Marušić, Z.; Avirović, M.; Blažičević, V.; Tomasović, Č.; Čerina, D.; Bajić, Ž.; Miše, B.P.; Lovasić, I.B.; et al. COVID-19 pandemic effects on breast cancer diagnosis in Croatia: A population-and registry-based study. Oncologist 2021, 26, e1156–e1160. [Google Scholar] [CrossRef]
Number of (%) Patients | |
---|---|
Level of education | |
Elementary school | 4 (5) |
High school | 45 (57) |
College | 30 (38) |
Marital status | |
Married | 44 (55.7) |
Extramarital union | 13 (16.5) |
Divorced | 18 (22.8) |
Widow | 4 (5.1) |
Work status | |
Employed | 53 (67) |
Unemployed | 25 (32) |
Physical appearance matters | 79 (100) |
Breast reconstruction | |
Only a mastectomy-non-reconstruction | 25 (31.6) |
Primary-immediate | 37 (46.8) |
Secondary-delayed | 17 (21.5) |
Have they undergone oncological therapy | |
Yes | 65 (82.3) |
No | 13 (16.5) |
Unanswered | 1 (1.3) |
What type of oncological therapy have they received | |
chemotherapy | 25 (37.8) |
radiotherapy (radiation) | 32 (48.4) |
hormon therapy | 9 (13.8) |
Clinical phase-PHD | |
I | 40 (50.6) |
II | 39(49.4) |
Sentinel lymph nodes | 72(91) |
Complications | 5 (6.3) |
Smoking | 36 (45.6) |
Hipertension | 21 (26.6) |
Diabetes | 8 (10.1) |
Domains SF-36 | Median (IQR) | p * | ||
---|---|---|---|---|
Only a Mastectomy (n = 25) (1) | Primary-Immediate Reconstruction (n = 37) (2) | Secondary-Deleyed Reconstruction (n = 17) (3) | ||
Physical health | ||||
Physical functioning | 30 (22.5–37.5) | 75 (60–85) | 70 (30–90) | <0.001 † |
Restriction due to physical difficulties | 18.8 (6.3–31.3) | 62.5 (50–98.4) | 75 (40.6–100) | <0.001 † |
Pain | 30 (30–40) | 75 (60–80) | 70 (35–95) | <0.001 † |
Perception of general health | 40 (36–52) | 67 (57–82) | 69.5 (44.5–82) | <0.001 † |
Mental health | ||||
Energy/vitality | 20 (15–25) | 60 (50–75) | 47.5 (31.3–78.8) | <0.001 † |
Social functioning | 50 (50–50) | 50 (50–62.5) | 50 (50–50) | >0.99 |
Limitation due to emotional difficulties | 16.7 (8.3–33.3) | 75 (52.08–100) | 75 (52.1–100) | <0.001 † |
Mental health | 24 (20–32) | 56 (48–72) | 56 (52–73) | <0.001 † |
Overall physical health | 31.6 (25.4–36.9) | 68.8 (57.4–80.9) | 74.3 (40.4–91.8) | <0.001 † |
Overall mental health | 28.5 (24.3–32.5) | 64.4 (52.0–72.1) | 57.3 (43.9–72.3) | <0.001 † |
Changes in health compared to last year | 50 (25–50) | 50 (50–75) | 50 (25–50) | <0.001 ‡ |
Medijan (IQR) | p * | |||
---|---|---|---|---|
Only a Mastectomy (n = 25) | Primary-Immediate Reconstruction (n = 37) | Secondary-Delayed Reconstruction (n = 17) | ||
QALY SF | 0.354 (0.313–0.436) | 0.427 (0.359–0.511) | 0.427 (0.348–0.539) | 0.08 |
Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. |
© 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
Pačarić, S.; Orkić, Ž.; Babić, M.; Farčić, N.; Milostić-Srb, A.; Lovrić, R.; Barać, I.; Mikšić, Š.; Vujanić, J.; Turk, T.; et al. Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients. Int. J. Environ. Res. Public Health 2022, 19, 8546. https://doi.org/10.3390/ijerph19148546
Pačarić S, Orkić Ž, Babić M, Farčić N, Milostić-Srb A, Lovrić R, Barać I, Mikšić Š, Vujanić J, Turk T, et al. Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients. International Journal of Environmental Research and Public Health. 2022; 19(14):8546. https://doi.org/10.3390/ijerph19148546
Chicago/Turabian StylePačarić, Stana, Želimir Orkić, Marko Babić, Nikolina Farčić, Andrea Milostić-Srb, Robert Lovrić, Ivana Barać, Štefica Mikšić, Jasenka Vujanić, Tajana Turk, and et al. 2022. "Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients" International Journal of Environmental Research and Public Health 19, no. 14: 8546. https://doi.org/10.3390/ijerph19148546