Patient reported outcomes associated with surgical intervention for breast cancer

Background: Patient reported outcomes (PROs) are an important addition to oncologic breast surgical care. The majority of BREAST-Q PRO literature has been focused on mastectomy with reconstruction (MR), with a paucity of information on more common surgical approaches in practice namely, breast conserving therapy (BCT) and mastectomy (M). This information will help inform patients around decision-making regarding surgical options.

Methods: 837 women underwent surgery between 2010 and 2012, and were later invited to complete the postoperative BREAST-Q module specific to their most recent surgery. Multivariate analysis was performed to compare BREAST-Q subscale scores between each of the three surgical cohorts.

Results: 257 women participated (161 BCT, 84 M, 12 MR). Patients undergoing BCT reported scores in the satisfaction with breasts domain 8 points higher than those undergoing mastectomy (p = 0.046). BCT also reported higher scores than mastectomy in the areas of psychosocial well being (12 points higher) as well as sexual well-being (17 points higher) (p = 0.0006).

Conclusions: BCT appears superior to mastectomy in terms of satisfaction with breasts, sexual well-being and now psychosocial well-being. Overall, BCT is associated with excellent patient reported outcomes.