Impact of Mastectomy Flap Necrosis on Patient-Reported Quality-of-Life Measures After Nipple-Sparing Mastectomy: A Preliminary Analysis.

Autor: Jones, V. Morgan, Nelson, Jonas A., Sevilimedu, Varadan, Le, Tiana, Allen Jr., Robert J., Mehrara, Babak J., Barrio, Andrea V., Capko, Deborah M., Heerdt, Alexandra S., Tadros, Audree B., Gemignani, Mary L., Morrow, Monica, Sacchini, Virgilio, Moo, Tracy-Ann
Zdroj: Annals of Surgical Oncology: An Oncology Journal for Surgeons; Oct2024, Vol. 31 Issue 10, p6795-6803, 9p
Abstrakt: Background: Mastectomy skin flap necrosis (SFN) is common following nipple-sparing mastectomy (NSM), but studies on its quality-of-life (QOL) impact are limited. We examined patient-reported QOL and satisfaction after NSM with/without SFN utilizing the BREAST-Q patient-reported outcome measure (PROM) survey. Patients and Methods: Patients undergoing NSM between April 2018 and July 2021 at our institution were examined; the BREAST-Q PROM was administered preoperatively, and at 6 months and 1 year postoperatively. SFN extent/severity was documented at 2–3 weeks postoperatively; QOL and satisfaction domains were compared between patients with/without SFN. Results: A total of 573 NSMs in 333 patients were included, and 135 breasts in 82 patients developed SFN (24% superficial, 56% partial thickness, 16% full thickness). Patients with SFN reported significantly lower scores in the satisfaction with breasts (p = 0.032) and psychosocial QOL domains (p = 0.009) at 6 months versus those without SFN, with scores returning to baseline at 1 year in both domains. In the "physical well-being-of-the-chest" domain, there was an overall decline in scores among all patients; however, there were no significant differences at any time point between patients with or without SFN. Sexual well-being scores declined for patients with SFN compared with those without at 6 months and also at 1 year, but this did not reach significance (p = 0.13, p = 0.2, respectively). Conclusions: Patients undergoing NSM who developed SFN reported significantly lower satisfaction and psychosocial well-being scores at 6 months, which returned to baseline by 1 year. Physical well-being of the chest significantly declines after NSM regardless of SFN. Future studies with larger sample sizes and longer follow-up are needed to determine SFN's impact on long-term QOL. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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