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Quality-of-Life and Surgical Outcomes for Breast Cancer Patients Treated with Therapeutic Reduction Mammoplasty Versus Mastectomy with Immediate Reconstruction

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Therapeutic reduction mammoplasty (TRM) is a safe and effective surgical technique that has oncologic outcomes comparable with those achieved by mastectomy. This study aimed to compare surgical and patient-reported outcomes between breast cancer patients treated with TRM and those who had mastectomy with immediate reconstruction (MIR).

Methods

A 4-year, single-institution, retrospective cohort study analyzed breast cancer patients undergoing TRM and MIR. Patient characteristics and perioperative data were collected from electronic records. Patient-reported outcome data were collected via BREAST-Q questionnaires preoperatively, then 3 months and 12 months postoperatively. A subgroup analysis was performed on locally advanced breast cancer (LABC) patients for TRM and MIR.

Results

The study included 249 breast reconstructions, of which 77 (31%) were TRM and 172 (69%) were MIR. The mean follow-up time was 2.4 ± 1.2 years. Compared with MIR, TRM had significantly lower major complication rates (9% vs 21%; p = 0.02) and fewer revisionary surgeries (5% vs 37%; p < 0.0001). At 1 year postoperatively, TRM had a significantly greater change in satisfaction with breasts, (+ 27.7 vs + 4.6; p < 0.01) and sexual well-being (+ 20.0 vs – 5.5; p = 0.02) than MIR.

Conclusion

For select breast cancer patients, TRM continues to be a safe and effective alternative to mastectomy. The current study demonstrated that TRM patients had fewer major complications and revisionary surgeries, as well as better patient-reported outcomes than MIR.

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Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, University of Ottawa, Ottawa, ON, Canada

    Michael J. Stein MD & Jing Zhang MD, PhD, FRCSC

  2. Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada

    Aneesh Karir BHSc

  3. Division of General Surgery, University of Ottawa, Ottawa, ON, Canada

    Angel Arnaout MD, MSc, FRCSC, FACS, Amanda Roberts MD, MPH, FRCSC & Erin Cordeiro MD, MSc, FRCSC

  4. The Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON, Canada

    Tinghua Zhang MSc

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  1. Michael J. Stein MD
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  2. Aneesh Karir BHSc
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  7. Jing Zhang MD, PhD, FRCSC
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Correspondence to Jing Zhang MD, PhD, FRCSC.

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Stein, M.J., Karir, A., Arnaout, A. et al. Quality-of-Life and Surgical Outcomes for Breast Cancer Patients Treated with Therapeutic Reduction Mammoplasty Versus Mastectomy with Immediate Reconstruction. Ann Surg Oncol 27, 4502–4512 (2020). https://doi.org/10.1245/s10434-020-08574-8

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  • DOI: https://doi.org/10.1245/s10434-020-08574-8

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