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Patient-Reported Outcomes in Patients Undergoing Lumpectomy With and Without Defect Closure

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

Abstract

Background

The effect of lumpectomy defect repair (a level 1 oncoplastic technique) on patient-reported breast satisfaction among patients undergoing lumpectomy has not yet been investigated.

Methods

Patients undergoing lumpectomy at our institution between 2018 and 2020 with or without repair of their lumpectomy defect during index operation, comprised our study population. The BREAST-Q quality-of-life questionnaire was administered preoperatively, and at 6 months, 1 year, and 2 years postoperatively. Satisfaction and quality-of-life domains were compared between those who did and did not have closure of their lumpectomy defect, and compared with surgeon-reported outcomes.

Results

A total of 487 patients met eligibility criteria, 206 (42%) had their partial mastectomy defect repaired by glandular displacement. Median breast volume, as calculated from the mammogram, was smaller in patients undergoing defect closure (826 cm3 vs. 895 cm3, p = 0.006). There were no statistically significant differences in satisfaction with breasts (SABTR), physical well-being of the chest (PWB-CHEST), or psychosocial well-being (PsychWB) scores between the two cohorts at any time point. While patients undergoing defect closure had significantly higher sexual well-being (SexWB) scores compared with no closure (66 vs. 59, p = 0.021), there were no predictors of improvement in SexWB scores over time on multivariable analysis. Patients’ self-reported scores positively correlated with physician-reported outcomes.

Conclusions

Despite a larger lumpectomy-to-breast volume ratio among patients undergoing defect repair, satisfaction was equivalent among those whose defects were or were not repaired at 2 years postsurgery. Defect repair was associated with clinically relevant improvement in patient-reported sexual well-being.

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Acknowledgments

This study was presented in poster format at the 24th Annual Meeting of the American Society of Breast Surgeons, April 26–30, 2023, Boston, MA. We thank Jessica Moore of Memorial Sloan Kettering Cancer Center for provision of editorial support.

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Author notes

  1. Emily Palmquist MD

    Present address: Department of Surgery, University of Washington, Seattle, WA, USA

Authors and Affiliations

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

    Emily Palmquist MD, Paula Garcia MHA, Tiana Le BS, Monica Morrow MD & Mahmoud El-Tamer MD

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

    Varadan Sevilimedu MBBS, DrPH & Xinyi Zhang BS

  3. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Katja Pinker-Domenig MD, PhD

  4. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Matthew G. Hanna MD

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

    Jonas A. Nelson MD, MPH

Authors
  1. Emily Palmquist MD
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  2. Varadan Sevilimedu MBBS, DrPH
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  3. Paula Garcia MHA
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  4. Tiana Le BS
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  6. Katja Pinker-Domenig MD, PhD
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  7. Matthew G. Hanna MD
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  8. Jonas A. Nelson MD, MPH
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  9. Monica Morrow MD
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  10. Mahmoud El-Tamer MD
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Corresponding author

Correspondence to Mahmoud El-Tamer MD.

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Disclosures

The preparation of this study was supported in part by NIH/NCI Cancer Center Support Grant P30CA008748 to Memorial Sloan Kettering Cancer Center. Sixth author Dr. Katja Pinker-Domenig has served on speaker bureaus for Bayer, Siemens Healthineers, Olea Medical, and Roche. She also has provided consulting/advisory services for Genentech, Merantix Healthcare, AURA Health Technologies GmbH, and Guerbet. No other authors have relationships with outside entities to disclose.

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Palmquist, E., Sevilimedu, V., Garcia, P. et al. Patient-Reported Outcomes in Patients Undergoing Lumpectomy With and Without Defect Closure. Ann Surg Oncol 31, 1615–1622 (2024). https://doi.org/10.1245/s10434-023-14584-z

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  • DOI: https://doi.org/10.1245/s10434-023-14584-z

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