Surgery and health-related quality of life – A prospective follow up study on breast cancer patients in Finland

Rautalin, Mervi; Jahkola, Tiina; Roine, Risto P.

doi:10.1016/j.ejso.2021.02.006

Cited by 13 publications

(27 citation statements)

References 28 publications

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“…If breast conserving surgery is not applicable, breast reconstruction is an option. Breast reconstruction improves health-related quality of life (HRQoL) after the initial shock of having cancer and going through cancer treatments [4].…”

Section: Introduction Backgroundmentioning

confidence: 99%

Breast Reconstruction–Prospective Follow up on Breast Cancer Patients’ Health‐Related Quality of Life

2022

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Background Analysing the results of breast reconstruction is important both in terms of oncological safety and health-related quality of life (HRQoL). Immediate breast reconstruction (IBR) is thought to be prone to complications and heavy for patients with no time to adapt to having cancer. Delayed reconstruction (DR) is an option after primary surgery and oncological treatments, but requires patients to go through two recovery periods after surgery. Methods A prospective study of 1065 breast cancer patients with repeated measurement of HRQoL with both generic (15D) and disease specific (EORTC QLQ C-30 BR23) measuring tools included 51 IBR patients and 41 DR patients. These patients’ HRQoL and reconstruction methods were studied in more detail alongside with clinical data to determine HRQoL levels for patients with IBR and those with mastectomy and DR during a 24-month follow-up. Measuring points were baseline, 3, 6, 12 and 24 months. Results Most frequent techniques used were abdominal flaps (IBR n = 16, DR n = 14), latissimus dorsi flaps (LD) (IBR n = 19, DR n = 10), implants (IBR n = 12) and fat grafting (DR n = 6). Smaller groups were excluded from group comparisons. Approximately one third of the patients encountered complications. Symptom scores did not differ between reconstruction methods. DR patients had better overall HRQoL at 12 months, but at 24 months the situation had changed in favour of IBR. Both approaches of reconstructive surgery produced good HRQoL with no significant differences between the approaches studied.

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Section: Introduction Backgroundmentioning

confidence: 99%

Breast Reconstruction–Prospective Follow up on Breast Cancer Patients’ Health‐Related Quality of Life

2022

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“…What is costly and what is not? We know from our previous studies that the quality of life varies in relation to time, which can be seen as a natural course of encountering BC and recovering from it (22). We also know that there is little difference between IBR and DR patients' HRQoL in the time frame of two years (23).…”

Section: Discussionmentioning

confidence: 99%

The Cost of Breast Cancer Surgery – Is the Money Spent Reflected on Health-related Quality of Life?

Rautalin

Jahkola

Roine

2022

In Vivo

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Background/Aim: Different treatment options of breast cancer (BC) are dependent on certain cancer-and patient-related features. The cost of treatment varies among patients. This study describes the cost distribution in the treatment of Finnish patients with BC for two years and relates the costs to important outcomes of modern BC treatment. Patients and Methods: Health-related quality of life (HRQoL) of 1,065 patients was measured prospectively at baseline, and 3, 6, 12, and 24 months thereafter with a generic (15D) and a disease-specific (EORTC QLQ C-30 BR23) HRQoL-instrument. Clinical data and costs of care were collected from hospital records. Patients were divided into four groups according to the surgical approach: breastconserving surgery (BCS n=661), mastectomy (n=319), immediate reconstruction (IBR n=51), and delayed reconstruction (DR n=34), and the costs according to the clinic responsible for treatment: oncological-, breast surgery-, and plastic surgery unit. Total costs of care during follow-up are presented groupwise alongside HRQoL results. Results: The mean total cost for BC surgery was 6,015 Euros for BCS,8,114 euros for mastectomy, 18,217 Euros for IBR, and 19,041 Euros for DR. BCS, IBR, and DR produced good HRQoL. Mastectomy patients had the lowest overall HRQoL and highest cost accumulation at the oncology unit. HRQoL of IBR and DR patients was similar. Conclusion: DR produces good HRQoL but generates the highest costs of care. If patients that require reconstruction could be identified earlier and offered IBR instead of mastectomy followed by later DR, the costs of care might be reduced.

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“…Loss of breasts due to breast cancer and its treatment can negatively affect a person's quality of life in multiple ways, including their body image [1][2][3][4][5] and sexual well-being [1][2][3][4]. By re-creating a breast form that is satisfying to the patient, breast reconstruction can mitigate detrimental changes in quality of life associated with complete or partial mastectomy [1,[6][7][8][9]. Many surgical techniques can be employed for breast reconstruction [10][11][12], with most falling into the broad categories of implant-based or autologous reconstruction.…”

Section: Introductionmentioning

confidence: 99%

Impact of Autologous Breast Reconstruction on Bra Fit

Liu

Khan

Bordes

et al. 2023

Preprint

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Purpose To inform bra design by analyzing 3D surface images of breast cancer patients who underwent autologous breast reconstruction.Methods We computed bra design measurements on 3D surface images of patients who underwent unilateral and bilateral autologous breast reconstruction. Breast measurements and right-left symmetry between preoperative baseline and postoperative time points were compared using either paired Student t test or Wilcoxon signed rank test, depending on the data's distribution. Regression analysis determined associations between measurements and patient characteristics such as age. Postoperative measurements and symmetry differences were also compared between autologous and implant-based breast reconstruction.Results Among participants who underwent bilateral autologous breast reconstruction, the reconstructed breasts were smaller and positioned higher on the chest wall than their native breasts. For patients who underwent unilateral reconstruction, similar postoperative changes were observed in the contralateral breast due to symmetry procedures. Overall, for participants whose baseline breast measurements showed substantial asymmetry, unilateral reconstruction decreased right-left asymmetry whereas bilateral reconstruction amplified right-left asymmetry. Preoperative baseline breast measurements, age, and BMI were statistically significantly associated with most postoperative breast measurements for participants who underwent bilateral autologous reconstruction. Compared to implant-based reconstruction, autologous reconstruction resulted in fewer changes in breast shape and symmetry that are pertinent to bra fit.Conclusion Preoperative baseline breast measurements, age, and BMI can impact bra designs for breast cancer survivors who undergo autologous reconstruction due to size, shape, and symmetry changes. Bra needs of people who undergo autologous reconstruction differ from those who undergo implant-based reconstruction.

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Surgery and health-related quality of life – A prospective follow up study on breast cancer patients in Finland

Cited by 13 publications

References 28 publications

Breast Reconstruction–Prospective Follow up on Breast Cancer Patients’ Health‐Related Quality of Life

Breast Reconstruction–Prospective Follow up on Breast Cancer Patients’ Health‐Related Quality of Life

The Cost of Breast Cancer Surgery – Is the Money Spent Reflected on Health-related Quality of Life?

Impact of Autologous Breast Reconstruction on Bra Fit

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