A National Snapshot of Satisfaction with Breast Cancer Procedures
Purpose Women with early-stage breast cancer face the complex decision to undergo one of three equally effective oncologic surgical strategies: breast-conservation surgery with radiation (BCS), mastectomy, or mastectomy with breast reconstruction. With comparable oncologic outcomes and survival rate...
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Published in | Annals of surgical oncology Vol. 22; no. 2; pp. 361 - 369 |
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Main Authors | , , , , , , , , |
Format | Journal Article |
Language | English |
Published |
Boston
Springer US
01.02.2015
Springer Nature B.V |
Subjects | |
Online Access | Get full text |
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Abstract | Purpose
Women with early-stage breast cancer face the complex decision to undergo one of three equally effective oncologic surgical strategies: breast-conservation surgery with radiation (BCS), mastectomy, or mastectomy with breast reconstruction. With comparable oncologic outcomes and survival rates, evaluations of satisfaction with these procedures are needed to facilitate the decision-making process and to optimize long-term health.
Methods
Women recruited from the Army of Women with a history of breast cancer surgery took electronically administered surgery-specific surveys, including the BREAST-Q© and a background survey evaluating patient-, disease-, and procedure-specific factors. Descriptive statistics and regression analysis were used to evaluate the effect of procedure type on breast satisfaction scores.
Results
Overall, 7,619 women completed the questionnaires. Linear regression revealed that women who underwent abdominal flap, or buttock or thigh flap reconstruction reported the highest breast satisfaction score, scoring an average of 5.6 points and 14.4 points higher than BCS, respectively (
p
< 0.0001 and
p
= 0.027, respectively). No difference in satisfaction was observed in women who underwent latissimus dorsi flap reconstruction compared with those who underwent BCS. Women who underwent implant reconstruction reported scores 8.6 points lower than BCS (
p
< 0.0001). Those with mastectomies without reconstruction or complex surgical histories scored, on average, 10 points lower than BCS (
p
< 0.0001).
Conclusion
Women who underwent autologous tissue reconstruction reported the highest breast satisfaction, while women undergoing mastectomy without reconstruction reported the lowest satisfaction. These findings emphasize the value of patient-reported outcome measures as an important guide to decision making in breast surgery and underscore the importance of multidisciplinary participation early in the surgical decision-making process. |
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AbstractList | Women with early-stage breast cancer face the complex decision to undergo one of three equally effective oncologic surgical strategies: breast-conservation surgery with radiation (BCS), mastectomy, or mastectomy with breast reconstruction. With comparable oncologic outcomes and survival rates, evaluations of satisfaction with these procedures are needed to facilitate the decision-making process and to optimize long-term health.
Women recruited from the Army of Women with a history of breast cancer surgery took electronically administered surgery-specific surveys, including the BREAST-Q© and a background survey evaluating patient-, disease-, and procedure-specific factors. Descriptive statistics and regression analysis were used to evaluate the effect of procedure type on breast satisfaction scores.
Overall, 7,619 women completed the questionnaires. Linear regression revealed that women who underwent abdominal flap, or buttock or thigh flap reconstruction reported the highest breast satisfaction score, scoring an average of 5.6 points and 14.4 points higher than BCS, respectively (p < 0.0001 and p = 0.027, respectively). No difference in satisfaction was observed in women who underwent latissimus dorsi flap reconstruction compared with those who underwent BCS. Women who underwent implant reconstruction reported scores 8.6 points lower than BCS (p < 0.0001). Those with mastectomies without reconstruction or complex surgical histories scored, on average, 10 points lower than BCS (p < 0.0001).
Women who underwent autologous tissue reconstruction reported the highest breast satisfaction, while women undergoing mastectomy without reconstruction reported the lowest satisfaction. These findings emphasize the value of patient-reported outcome measures as an important guide to decision making in breast surgery and underscore the importance of multidisciplinary participation early in the surgical decision-making process. Women with early-stage breast cancer face the complex decision to undergo one of three equally effective oncologic surgical strategies: breast-conservation surgery with radiation (BCS), mastectomy, or mastectomy with breast reconstruction. With comparable oncologic outcomes and survival rates, evaluations of satisfaction with these procedures are needed to facilitate the decision-making process and to optimize long-term health. Women recruited from the Army of Women with a history of breast cancer surgery took electronically administered surgery-specific surveys, including the BREAST-Q© and a background survey evaluating patient-, disease-, and procedure-specific factors. Descriptive statistics and regression analysis were used to evaluate the effect of procedure type on breast satisfaction scores. Overall, 7,619 women completed the questionnaires. Linear regression revealed that women who underwent abdominal flap, or buttock or thigh flap reconstruction reported the highest breast satisfaction score, scoring an average of 5.6 points and 14.4 points higher than BCS, respectively (p < 0.0001 and p = 0.027, respectively). No difference in satisfaction was observed in women who underwent latissimus dorsi flap reconstruction compared with those who underwent BCS. Women who underwent implant reconstruction reported scores 8.6 points lower than BCS (p < 0.0001). Those with mastectomies without reconstruction or complex surgical histories scored, on average, 10 points lower than BCS (p < 0.0001). Women who underwent autologous tissue reconstruction reported the highest breast satisfaction, while women undergoing mastectomy without reconstruction reported the lowest satisfaction. These findings emphasize the value of patient-reported outcome measures as an important guide to decision making in breast surgery and underscore the importance of multidisciplinary participation early in the surgical decision-making process. Purpose Women with early-stage breast cancer face the complex decision to undergo one of three equally effective oncologic surgical strategies: breast-conservation surgery with radiation (BCS), mastectomy, or mastectomy with breast reconstruction. With comparable oncologic outcomes and survival rates, evaluations of satisfaction with these procedures are needed to facilitate the decision-making process and to optimize long-term health. Methods Women recruited from the Army of Women with a history of breast cancer surgery took electronically administered surgery-specific surveys, including the BREAST-Q© and a background survey evaluating patient-, disease-, and procedure-specific factors. Descriptive statistics and regression analysis were used to evaluate the effect of procedure type on breast satisfaction scores. Results Overall, 7,619 women completed the questionnaires. Linear regression revealed that women who underwent abdominal flap, or buttock or thigh flap reconstruction reported the highest breast satisfaction score, scoring an average of 5.6 points and 14.4 points higher than BCS, respectively ( p < 0.0001 and p = 0.027, respectively). No difference in satisfaction was observed in women who underwent latissimus dorsi flap reconstruction compared with those who underwent BCS. Women who underwent implant reconstruction reported scores 8.6 points lower than BCS ( p < 0.0001). Those with mastectomies without reconstruction or complex surgical histories scored, on average, 10 points lower than BCS ( p < 0.0001). Conclusion Women who underwent autologous tissue reconstruction reported the highest breast satisfaction, while women undergoing mastectomy without reconstruction reported the lowest satisfaction. These findings emphasize the value of patient-reported outcome measures as an important guide to decision making in breast surgery and underscore the importance of multidisciplinary participation early in the surgical decision-making process. PURPOSEWomen with early-stage breast cancer face the complex decision to undergo one of three equally effective oncologic surgical strategies: breast-conservation surgery with radiation (BCS), mastectomy, or mastectomy with breast reconstruction. With comparable oncologic outcomes and survival rates, evaluations of satisfaction with these procedures are needed to facilitate the decision-making process and to optimize long-term health.METHODSWomen recruited from the Army of Women with a history of breast cancer surgery took electronically administered surgery-specific surveys, including the BREAST-Q© and a background survey evaluating patient-, disease-, and procedure-specific factors. Descriptive statistics and regression analysis were used to evaluate the effect of procedure type on breast satisfaction scores.RESULTSOverall, 7,619 women completed the questionnaires. Linear regression revealed that women who underwent abdominal flap, or buttock or thigh flap reconstruction reported the highest breast satisfaction score, scoring an average of 5.6 points and 14.4 points higher than BCS, respectively (p < 0.0001 and p = 0.027, respectively). No difference in satisfaction was observed in women who underwent latissimus dorsi flap reconstruction compared with those who underwent BCS. Women who underwent implant reconstruction reported scores 8.6 points lower than BCS (p < 0.0001). Those with mastectomies without reconstruction or complex surgical histories scored, on average, 10 points lower than BCS (p < 0.0001).CONCLUSIONWomen who underwent autologous tissue reconstruction reported the highest breast satisfaction, while women undergoing mastectomy without reconstruction reported the lowest satisfaction. These findings emphasize the value of patient-reported outcome measures as an important guide to decision making in breast surgery and underscore the importance of multidisciplinary participation early in the surgical decision-making process. |
Author | Samsa, Gregory P. Cox, Charlie E. Rushing, Christel N. Abernethy, Amy P. Zenn, Michael R. Atisha, Dunya M. Shelley Hwang, E. Locklear, Tracie D. Pusic, Andrea L. |
Author_xml | – sequence: 1 givenname: Dunya M. surname: Atisha fullname: Atisha, Dunya M. email: datisha@health.usf.edu organization: Division of Plastic Surgery, Department of Surgery, Morsani College of Medicine, University of South Florida – sequence: 2 givenname: Christel N. surname: Rushing fullname: Rushing, Christel N. organization: Department of Biostatistics and Bioinformatics, Duke University Medical Center – sequence: 3 givenname: Gregory P. surname: Samsa fullname: Samsa, Gregory P. organization: Department of Biostatistics and Bioinformatics, Duke University Medical Center – sequence: 4 givenname: Tracie D. surname: Locklear fullname: Locklear, Tracie D. organization: Center for Learning Health Care, Duke University Medical Center – sequence: 5 givenname: Charlie E. surname: Cox fullname: Cox, Charlie E. organization: Division of Breast Surgery, Department of Surgery, Morsani College of Medicine, University of South Florida – sequence: 6 givenname: E. surname: Shelley Hwang fullname: Shelley Hwang, E. organization: Division of Surgical Oncology, Department of Surgery, Duke University Medical Center – sequence: 7 givenname: Michael R. surname: Zenn fullname: Zenn, Michael R. organization: Division of Plastic Surgery, Department of Surgery, Duke University Medical Center – sequence: 8 givenname: Andrea L. surname: Pusic fullname: Pusic, Andrea L. organization: Plastic and Reconstructive Surgery, Memorial Sloan Kettering Cancer Center – sequence: 9 givenname: Amy P. surname: Abernethy fullname: Abernethy, Amy P. organization: Center for Learning Health Care, Duke University Medical Center, Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/25465378$$D View this record in MEDLINE/PubMed |
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Keywords | Breast Cancer Contralateral Breast Contralateral Prophylactic Mastectomy Flap Reconstruction Breast Reconstruction |
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Women with early-stage breast cancer face the complex decision to undergo one of three equally effective oncologic surgical strategies:... Women with early-stage breast cancer face the complex decision to undergo one of three equally effective oncologic surgical strategies: breast-conservation... PURPOSEWomen with early-stage breast cancer face the complex decision to undergo one of three equally effective oncologic surgical strategies:... |
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SubjectTerms | Breast Implantation Breast Neoplasms - radiotherapy Breast Neoplasms - surgery Breast Oncology Decision Making Female Humans Linear Models Mammaplasty Mastectomy Mastectomy, Segmental Medicine Medicine & Public Health Middle Aged Oncology Patient Satisfaction Surgery Surgical Oncology |
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Title | A National Snapshot of Satisfaction with Breast Cancer Procedures |
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