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Impact of Immediate and Delayed Breast Reconstruction on Quality of Life of Breast Cancer Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19148546. [PMID: 35886396 PMCID: PMC9323042 DOI: 10.3390/ijerph19148546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 07/05/2022] [Accepted: 07/11/2022] [Indexed: 02/01/2023]
Abstract
A mastectomy affects the psychological, social, and sexual well-being of patients. Research has confirmed that breast reconstruction is important for improving the quality of life in patients with breast cancer. The aim of this study was to assess the quality of life of patients who underwent a mastectomy followed by immediate or delayed breast reconstruction. This prospective study was conducted from January 2018 to March 2020 at the Clinical Hospital Center Osijek, using the health questionnaire SF-36. The study included 79 patients. The results of the study showed that patients who underwent a mastectomy had the lowest scores in the domain of restriction due to physical difficulties, 18.8 (6.3−31.3), in physical functioning and limitation due to emotional difficulties, 16.7 (8.3−33.3), in mental health. In immediate breast reconstruction, patients rated better physical health (p < 0.001), while patients who underwent delayed breast reconstruction rated their mental health worse (p < 0.001) as measured by the SF-36 questionnaire. Conclusion: The results of this study show that patients without breast reconstruction rated their quality of life worse than patients who underwent immediate and delayed breast reconstruction after mastectomy. There is no difference in the quality of life between patients who underwent immediate and delayed breast reconstruction after mastectomy.
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Letsiou E, Tsakatikas S, Vakis G, Tsapakidis K, Charalampakis N, Diamantis A, Poultsidi A, Michelakis D, de Bree E, Mauri D, Tsoukalas N, Antoniades C, Tolia M. Radiotherapy and Breast Reconstruction: What Is the Ideal Timing? A Narrative Review. Rev Recent Clin Trials 2022; 17:73-85. [PMID: 35289255 DOI: 10.2174/1574887117666220314161609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 11/13/2021] [Accepted: 12/24/2021] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Women undergoing mastectomy choose to pursue breast reconstruction (BR) in order to reduce their body image distress.Adjuvant chest wall irradiation is associated with a negative cosmetic outcome. The aim of our review was to identify the optimal timing of BR relating to radiotherapy delivery. MATERIALS AND METHODS Using Cochrane Library, Embase, PubMed, Springer, Wanfang and CNKI, we performed a non-systematic review of articles published up to August 2021. RESULTS There is no hard evidence in favor of immediate, delayed or 2-stage BR when post-mastectomy radiation is indicated. Immediate and 2-stage BR seem to be valid alternatives to delayed BR. CONCLUSIONS Further research is essential in order to assess clinician and patient reported aesthetic outcomes and determine the optimal timing of BR in view of post-mastectomy radiotherapy, in breast cancer survivors.
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Affiliation(s)
| | - Sergios Tsakatikas
- Department of Medical Oncology, Metaxa Cancer Hospital, 185 37 Athens, Greece
| | - George Vakis
- Plastic Surgery Clinic, Evangelismos General Hospital, Ipsilantou 45-47, 106 76, Athens, Greece
| | - Konstantinos Tsapakidis
- Department of Oncology, Faculty of Medicine, School of Health Sciences, University of Thessaly, Biopolis, 41500, Larisa, Greece
| | | | - Alexandros Diamantis
- Department of Surgery, Medical School, University of Thessaly, 415 00 Larissa, Greece
| | - Antigoni Poultsidi
- Department of Surgery, Medical School, University of Thessaly, 415 00 Larissa, Greece
| | - Dimosthenis Michelakis
- Department of Surgical Oncology, Medical School of Crete University Hospital, 711 10 Heraklion, Greece
| | - Eelco de Bree
- Department of Surgical Oncology, Medical School of Crete University Hospital, 711 10 Heraklion, Greece
| | - Davide Mauri
- Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.,Department of Medical, Oncology, Greece Society for Study of Clonal Heterogeneity of Neoplasia (EMEKEN), University Hospital of Ioannina, Ioannina, Greece
| | - Nikolaos Tsoukalas
- Department of Oncology, 401 General Military Hospital of Athens, 115 25, Athens, Greece
| | - Chrysostomos Antoniades
- Department of Radiotherapy, School of Medicine, University of Crete, 711 10, Heraklion, Greece
| | - Maria Tolia
- Department of Radiotherapy, School of Medicine, University of Crete, 711 10, Heraklion, Greece
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Breast reconstruction after therapeutic or prophylactic mastectomy for breast cancer: A comparison of guideline recommendations. Eur J Surg Oncol 2020; 46:1046-1051. [PMID: 32057564 DOI: 10.1016/j.ejso.2020.01.024] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 01/07/2020] [Accepted: 01/16/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The purpose of this article is to illuminate differences in published clinical practice guideline recommendations for breast reconstruction after prophylactic and therapeutic mastectomy. METHODS Ten guidelines were identified through a systematic search of websites and databases of reputable oncology guideline developers, and key differences and gaps in recommendations were noted. Quality assessment of the guidelines was conducted by three reviewers using the AGREE II tool, focusing on breast reconstruction specific documents rather than the general breast cancer guidelines. RESULTS The most comprehensive guidelines were published by Alberta Health Services, Cancer Care Ontario, the American Society of Plastic Surgeons, and the Association of Breast Surgery/British Association of Plastic Reconstructive and Aesthetic Surgeons. AGREE II scores in the domains of "Scope and Purpose" and "Clarity and Presentation" were ranked relatively high for all four guidelines while "Applicability" and "Editorial Independence" were ranked relatively low. The Alberta and Ontario guidelines were the overall highest ranked guidelines across all domains. CONCLUSION Overall, these guidelines provide consistent recommendations on who should receive breast reconstruction education, who is a candidate for postmastectomy breast reconstruction, and the appropriate timing of reconstruction and extent of mastectomy. Future updates from all should focus on expanding to include alloplastic and autologous forms of reconstruction and should include a broad scope of relevant questions.
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Thiboutot E, Craighead P, Webb C, Temple-Oberle C. Patient-Reported Satisfaction Following Radiation of Implant-Based Breast Reconstruction. Plast Surg (Oakv) 2019; 27:147-155. [PMID: 31106173 DOI: 10.1177/2292550319826090] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Little is known with regard to patient-reported outcomes (PROs) in the setting of implant-based reconstruction (IBR) with post-mastectomy radiation therapy (PMRT). Methods We identified patients who underwent immediate IBR from a prospectively compiled database. The Breast Reconstruction Satisfaction Questionnaire (BRECON-31) was scored and compared between patients with and without PMRT. Results Sixty-four women met the study criteria. Forty-eight did not receive PMRT and 16 did. Nine women had an unanticipated indication for PMRT. The PMRT group was similar to the control group with regard to baseline characteristics (ie, age, marital status, body mass index, tobacco use, and comorbidities). However, treatment and oncologic characteristics (eg, diagnosis, tumour characteristics, systemic therapy use) differed. Of all complications, only capsular contracture rates differed (1.2% vs 13%; P = .01). Of the 9 subscales, 7 showed no difference in satisfaction between the groups. Radiated women scored lower in the arm concerns and breast appearance subscales. Scores were similar whether the indication for PMRT had been anticipated or not. Discussion Women with immediate IBR scored similarly to their nonradiated counterparts across 7 of 9 domains of satisfaction. Arm concerns and breast appearance scores are lower with PMRT, likely secondarily to more extensive nodal procedures in higher stage patients and to the side effect profile of radiotherapy. Our findings are in line with the few available studies using other PRO tools to evaluate the impact of PMRT on patient satisfaction and studies objectively measuring the effect of PMRT on arm morbidity and cosmetic outcomes.
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Affiliation(s)
- Eva Thiboutot
- Division of General Surgery, Department of Surgery, Université de Montréal, Montréal, Québec, Canada
| | - Peter Craighead
- Division of Radiation Oncology, Department of Oncology, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada
| | - Carmen Webb
- Division of Surgical Oncology, Department of Oncology, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada
| | - Claire Temple-Oberle
- Division of Radiation Oncology, Department of Oncology, Tom Baker Cancer Centre, Alberta Health Services, Calgary, Alberta, Canada
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Offodile AC, Muldoon LD, Gani F, Canner JK, Jacobs LK. The site of care matters: An examination of the relationship between high Medicaid burden hospitals and the use, cost, and complications of immediate breast reconstruction after mastectomy. Cancer 2017; 124:346-355. [DOI: 10.1002/cncr.31046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Revised: 08/26/2017] [Accepted: 09/11/2017] [Indexed: 12/30/2022]
Affiliation(s)
- Anaeze C. Offodile
- Johns Hopkins Surgery Center for Outcomes Research; Johns Hopkins University School of Medicine; Baltimore Maryland
- Department of Plastic and Reconstructive Surgery; The University of Texas MD Anderson Cancer Center; Houston Texas
| | | | - Faiz Gani
- Johns Hopkins Surgery Center for Outcomes Research; Johns Hopkins University School of Medicine; Baltimore Maryland
| | - Joseph K. Canner
- Johns Hopkins Surgery Center for Outcomes Research; Johns Hopkins University School of Medicine; Baltimore Maryland
| | - Lisa K. Jacobs
- Johns Hopkins Surgery Center for Outcomes Research; Johns Hopkins University School of Medicine; Baltimore Maryland
- Department of Surgery; Johns Hopkins University School of Medicine; Baltimore Maryland
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Zhan W, Chang Q, Xiao X, Dong Z, Zeng Z, Gao J, Lu F. Self-synthesized extracellular matrix contributes to mature adipose tissue regeneration in a tissue engineering chamber. Wound Repair Regen 2015; 23:443-52. [PMID: 25847278 DOI: 10.1111/wrr.12292] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 03/26/2015] [Indexed: 12/01/2022]
Affiliation(s)
- Weiqing Zhan
- Department of Plastic and Cosmetic Surgery; Nanfang Hospital, Southern Medical University; Guangzhou Guangdong People's Republic of China
| | - Qiang Chang
- Department of Plastic and Cosmetic Surgery; Nanfang Hospital, Southern Medical University; Guangzhou Guangdong People's Republic of China
| | - Xiaolian Xiao
- Department of Plastic and Cosmetic Surgery; Nanfang Hospital, Southern Medical University; Guangzhou Guangdong People's Republic of China
| | - Ziqing Dong
- Department of Plastic and Cosmetic Surgery; Nanfang Hospital, Southern Medical University; Guangzhou Guangdong People's Republic of China
| | - Zhaowei Zeng
- Department of Plastic and Cosmetic Surgery; Nanfang Hospital, Southern Medical University; Guangzhou Guangdong People's Republic of China
| | - Jianhua Gao
- Department of Plastic and Cosmetic Surgery; Nanfang Hospital, Southern Medical University; Guangzhou Guangdong People's Republic of China
| | - Feng Lu
- Department of Plastic and Cosmetic Surgery; Nanfang Hospital, Southern Medical University; Guangzhou Guangdong People's Republic of China
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Silver JK. Cancer prehabilitation and its role in improving health outcomes and reducing health care costs. Semin Oncol Nurs 2014; 31:13-30. [PMID: 25636392 DOI: 10.1016/j.soncn.2014.11.003] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine the current state of cancer prehabilitation care and the impact that it may have on health-related and financial outcomes. DATA SOURCES Clinical trials, reviews and meta-analyses. CONCLUSION Research demonstrates that prehabilitation interventions may improve physical and/or psychological outcomes and help patients function at a higher level throughout their cancer treatment. Establishing a baseline status at diagnosis provides an opportunity to gain insight into the burden that cancer and its treatment can place on survivors with respect to physical and psychological impairments, function, and disability. Targeted interventions may reduce the incidence and/or severity of future impairments that often lead to reduced surgical complications, hospital lengths of stay, hospital readmissions, and overall health care costs. Thus, cancer prehabilitation is an opportunity to positively impact patient health-related and financial outcomes from diagnosis onward and, by decreasing the financial impact that cancer can have on individuals, may prove to be a sound investment for patients, hospitals, payers and society. IMPLICATIONS FOR NURSING PRACTICE Nurses, and particularly navigators, have an opportunity to significantly impact care through patient screening, prehabilitation assessments, documentation of baseline patient status and, in some cases, especially when impairments are not present at baseline, provide interventions designed to improve physical and psychological health before the start of upcoming oncology treatments and reduce the likelihood of patients developing future impairments.
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