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Patient-Reported Outcome Measures for Patients Who Have Clinical T4 Breast Cancer Treated via Mastectomy with and Without Reconstruction

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

Abstract

Background

Patients with clinical T4M0 breast cancer are recommended to undergo neoadjuvant chemotherapy, modified radical mastectomy, and postmastectomy radiotherapy. This study determined whether BREAST-Q scores differ by decision to pursue reconstruction or timing of reconstruction.

Methods

This retrospective, single-institutional study analyzed cT4 breast cancer patients from 2014 to 2021 without evidence of distant metastatic disease undergoing mastectomy with or without reconstruction. As routine care, BREAST-Q was administered preoperatively, then 6 months, 1 year, and 2 years postoperatively. Satisfaction and quality-of-life domains were compared between mastectomy with no reconstruction (NR), immediate reconstruction (IR), and delayed reconstruction (DR) groups.

Results

Of the 144 patients eligible for this study, 71 (49%) had NR, 36 (25%) had DR, and 37 (26%) had IR. The patients undergoing reconstruction were younger and more likely to elect contralateral prophylactic mastectomy. Timing of reconstruction was not associated with significant differences in satisfaction with breasts (SATBR) at any time point. For the patients who had DR, breast satisfaction increased over time after reconstructive surgery. Physical well-being of the chest (PWB-CHEST) did not significantly differ among IR, DR, and NR at any time point. The patients who underwent DR experienced improvement in PWB-CHEST scores from preoperative scores. The patients with IR and NR experienced PWB-CHEST decline over time. Psychosocial well-being (PSWB) did not differ significantly across time or by subgroup.

Conclusions

The patients with T4 breast cancer who elected reconstruction did not differ in patient-reported outcomes based on timing of reconstruction. In the DR cohort, SATBR significantly improved after reconstructive surgery. These data can help inform breast reconstructive decision-making for patients facing the choice among DR, IR, and NR.

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Acknowledgment

The preparation of this study was supported in part by NIH/NCI Cancer Center Support grant no. P30 CA008748 to Memorial Sloan Kettering Cancer Center.

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Authors and Affiliations

  1. Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Emily Palmquist MD, Kate R. Pawloski MD, MPH, Paula Garcia MHA, Tracy-Ann Moo MD, Monica Morrow MD & Audree B. Tadros MD, MPH

  2. Department of Surgery, Weill Cornell Medicine and New York-Presbyterian, New York, NY, USA

    Jessica Limberg MD

  3. Plastic and Reconstructive Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Jacqueline J. Chu BA & Jonas A. Nelson MD, MPH

  4. Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Charlie White MS, Raymond E. Baser MS & Varadan Sevilimedu MBBS, DrPH

Authors
  1. Emily Palmquist MD
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  2. Jessica Limberg MD
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  3. Jacqueline J. Chu BA
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  4. Charlie White MS
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  5. Raymond E. Baser MS
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  6. Varadan Sevilimedu MBBS, DrPH
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  7. Kate R. Pawloski MD, MPH
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  8. Paula Garcia MHA
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  9. Jonas A. Nelson MD, MPH
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  10. Tracy-Ann Moo MD
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  11. Monica Morrow MD
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  12. Audree B. Tadros MD, MPH
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Corresponding author

Correspondence to Audree B. Tadros MD, MPH.

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Disclosure

Dr. Monica Morrow has received honoraria from Exact Sciences and Roche. The remaining authors have no conflicts of interest.

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Palmquist, E., Limberg, J., Chu, J.J. et al. Patient-Reported Outcome Measures for Patients Who Have Clinical T4 Breast Cancer Treated via Mastectomy with and Without Reconstruction. Ann Surg Oncol 30, 115–121 (2023). https://doi.org/10.1245/s10434-022-12560-7

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  • DOI: https://doi.org/10.1245/s10434-022-12560-7

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