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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 3/2024

08-12-2023 | Mastectomy | Breast Oncology

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

Authors: Emily Palmquist, MD, Varadan Sevilimedu, MBBS, DrPH, Paula Garcia, MHA, Tiana Le, BS, Xinyi Zhang, BS, Katja Pinker-Domenig, MD, PhD, Matthew G. Hanna, MD, Jonas A. Nelson, MD, MPH, Monica Morrow, MD, Mahmoud El-Tamer, MD

Published in: Annals of Surgical Oncology | Issue 3/2024

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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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Metadata
Title
Patient-Reported Outcomes in Patients Undergoing Lumpectomy With and Without Defect Closure
Authors
Emily Palmquist, MD
Varadan Sevilimedu, MBBS, DrPH
Paula Garcia, MHA
Tiana Le, BS
Xinyi Zhang, BS
Katja Pinker-Domenig, MD, PhD
Matthew G. Hanna, MD
Jonas A. Nelson, MD, MPH
Monica Morrow, MD
Mahmoud El-Tamer, MD
Publication date
08-12-2023
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 3/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-14584-z

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