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Rogowsky L, Illmann CF, Macadam SA, Lennox PA, Van Laeken N, Bovill ES, Doherty C, Isaac KV. Prevalence and Severity of Chronic Pain in Patients Receiving Mastectomy with Alloplastic Immediate Breast Reconstruction: A Survey Study. Plast Surg (Oakv) 2024; 32:415-422. [PMID: 39104921 PMCID: PMC11298134 DOI: 10.1177/22925503221128985] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/07/2024] Open
Abstract
Introduction: Breast cancer is the most frequently diagnosed cancer worldwide. For those undergoing mastectomy, the choice of alloplastic immediate breast reconstruction (IBR) is increasingly favored. Post-operative chronic pain is an important consideration in this decision, but there is a paucity of data for those undergoing alloplastic IBR. We sought to examine the prevalence, severity, and risk factors for the development of chronic pain in this cohort using validated patient-reported outcome measures. Methods: A cross-sectional survey study was conducted among patients receiving mastectomy with alloplastic IBR. Participants completed 3 surveys querying chronic pain, specifically the Breast Cancer Pain Questionnaire (BCPQ), Brief Pain Inventory (BPI), and BREAST-Q. Participant medical records were reviewed for demographic and surgical variables. Results: A total of 118 patients participated in the study-a response rate of 33.6%. Chronic pain prevalence was high (52.5%), and only 29.0% of these patients had consulted a physician regarding their pain. Among those reporting chronic pain (n = 62), the median severity of pain was 3.1 on an 11-point scale. Chronic pain was associated with radiation (p = .018), bilateral reconstruction (p = .05), worse emotional health (p = .0003), less self (p = .022), and sexual confidence (p = .044). Inter-tool reliability was high, with no significant difference in responses between the 3 surveys. Conclusion: In this cohort, chronic pain is supported as a significant concern among patients who have undergone mastectomy with alloplastic IBR. Given the burden of chronic pain, there is an opportunity to intervene with preventative measures and support for its management.
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Affiliation(s)
- Larissa Rogowsky
- Division of Plastic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Caroline F. Illmann
- Division of Plastic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Sheina A. Macadam
- Division of Plastic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Peter A. Lennox
- Division of Plastic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Nancy Van Laeken
- Division of Plastic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Esta S. Bovill
- Division of Plastic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Christopher Doherty
- Division of Plastic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
| | - Kathryn V. Isaac
- Division of Plastic Surgery, University of British Columbia, Vancouver, British Columbia, Canada
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Nsaful J, Nartey ET, Dedey F, Bediako-Bowan A, Appiah-Danquah R, Darko K, Ankrah LNA, Akli-Nartey C, Annan JY, Dei-Asamoa J, Ahene-Amanquanor GA, Clegg-Lamptey JN. Quality of Life after Mastectomy with or without Breast Reconstruction and Breast-Conserving Surgery in Breast Cancer Survivors: A Cross-Sectional Study at a Tertiary Hospital in Ghana. Curr Oncol 2024; 31:2952-2962. [PMID: 38920708 PMCID: PMC11203203 DOI: 10.3390/curroncol31060224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 05/18/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
(1) Background: Breast cancer is the leading malignancy worldwide, and in Ghana, it has a poor overall survival rate. However, approximately 50% of cases are cases of early-stage disease, and with advances in breast cancer treatment and improvements in survival, quality of life (QOL) is becoming as important as the treatment of the disease. (2) Methodology: This was a cross-sectional study of survivors who had breast-conserving surgery (BCS), mastectomy only (M) and mastectomy with breast reconstruction (BRS) from 2016 to 2020 at a tertiary hospital in Ghana, comparatively assessing their QOL using EORTC QLQ C-30 and EORTC QLQ BR-23. (3) Results: The study participants had an overall global health status (GHS) median score of 83.3 [IQR: 66.7-91.7] with no significant differences between the surgery types. The BRS group had statistically significant lower median scores for the functional scale (82.8 and 51.0) and the highest scores for the symptomatic scale (15.7 and 16.5). Body image was significantly lowest for the BRS group (83.3) [68.8-91.7] and highest (100) [91.7-100] for the BCS group (p < 0.001). (4) Conclusion: There is a need to develop support systems tailored at improving the QOL of breast cancer survivors taking into consideration the type of surgery performed.
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Affiliation(s)
- Josephine Nsaful
- Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra GA-221-1570, Ghana; (F.D.); (A.B.-B.); (J.-N.C.-L.)
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Edmund Tetteh Nartey
- Centre for Tropical Clinical Pharmacology & Therapeutics, University of Ghana Medical School, Accra GA-221-1570, Ghana;
| | - Florence Dedey
- Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra GA-221-1570, Ghana; (F.D.); (A.B.-B.); (J.-N.C.-L.)
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Antoinette Bediako-Bowan
- Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra GA-221-1570, Ghana; (F.D.); (A.B.-B.); (J.-N.C.-L.)
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Rita Appiah-Danquah
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Kwame Darko
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (K.D.); (L.N.A.A.)
| | - Levi Nii Ayi Ankrah
- National Reconstructive Plastic Surgery and Burns Centre, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (K.D.); (L.N.A.A.)
| | - Cynthia Akli-Nartey
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Jessie Yaoteokor Annan
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | - Jessica Dei-Asamoa
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
| | | | - Joe-Nat Clegg-Lamptey
- Department of Surgery, University of Ghana Medical School, College of Health Sciences, University of Ghana, Accra GA-221-1570, Ghana; (F.D.); (A.B.-B.); (J.-N.C.-L.)
- Department of Surgery, Korle Bu Teaching Hospital, Accra GA-221-1570, Ghana; (R.A.-D.); (C.A.-N.); (J.Y.A.); (J.D.-A.); (G.A.A.-A.)
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