Nipple-areolar Complex Reconstruction following Postmastectomy Breast Reconstruction: A Comparative Utility Assessment Study

Autor: Ahmed M. S. Ibrahim, MD, Hani H. Sinno, MD, MEng, Ali Izadpanah, MD, MSc, Joshua Vorstenbosch, PhD, Tassos Dionisopoulos, MD, Marc A. M. Mureau, MD, PhD, Adam M. Tobias, MD, Bernard T. Lee, MD, MBA, Samuel J. Lin, MD
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Zdroj: Plastic and Reconstructive Surgery, Global Open, Vol 3, Iss 4, p e380 (2015)
Druh dokumentu: article
ISSN: 2169-7574
00000000
DOI: 10.1097/GOX.0000000000000133
Popis: Background: Nipple-areola complex (NAC) reconstruction occurs toward the final stage of breast reconstruction; however, not all women follow through with these procedures. The goal of this study was to determine the impact of the health state burden of living with a reconstructed breast before NAC reconstruction. Methods: A sample of the population and medical students at McGill University were recruited to establish the utility scores [visual analog scale (VAS), time trade-off (TTO), and standard gamble (SG)] of living with an NAC deformity. Utility scores for monocular and binocular blindness were determined for validation and comparison. Linear regression and Student’s t test were used for statistical analysis, and significance was set at P < 0.05. Results: There were 103 prospective volunteers included. Utility scores (VAS, TTO, and SG) for NAC deformity were 0.84 ± 0.18, 0.92 ± 0.11, and 0.92 ± 0.11, respectively. Age, gender, and ethnicity were not statistically significant independent predictors of utility scores. Income thresholds of $10,000 revealed a statistically significant difference for VAS (P = 0.049) and SG (P = 0.015). Linear regression analysis showed that medical education was directly proportional to the SG and TTO scores (P < 0.05). Conclusions: The absence of NAC in a reconstructed breast can be objectively assessed using utility scores (VAS, 0.84 ± 0.18; TTO, 0.92 ± 0.11; SG, 0.92 ± 0.11). In comparison to prior reported conditions, the quality of life in patients choosing to undergo NAC reconstruction is similar to that of persons living with a nasal deformity or an aging neck requiring rejuvenation.
Databáze: Directory of Open Access Journals
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