The impact of age on patient-reported outcomes after oncoplastic versus conventional breast cancer surgery

Ritter, Mathilde; Ling, Barbara; Oberhauser, Ida; Montagna, Giacomo; Zehnpfennig, Lea; Lévy, Jérémy; Soysal, Savas D.; Castrezana, Liliana; Müller, Mathias D.; Schwab, Fabienne D.; Kurzeder, Christian; Haug, Martin; Weber, Walter

doi:10.1007/s10549-021-06126-6

Cited by 17 publications

(16 citation statements)

References 27 publications

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“…Meanwhile younger patients seem to elect more often to undergo reconstructive breast surgery, aiming for the best possible aesthetic result, while surgeons tend to recommend the least invasive surgery to older patients to decrease the risk of complications even further. [32] There are several strengths to our study. We used only marginal exclusion criteria, which makes this study unique, depicting a real world setting of a tertiary breast cancer referral center.…”

Section: Interval Between Nst and Surgerymentioning

confidence: 99%

The Impact of Neoadjuvant Systemic Treatment on Postoperative Complications in Breast Cancer Surgery

Maggi

Nussbaumer

Castrezana

et al. 2022

Preprint

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Purpose: The aim of the study was to analyse the impact of neoadjuvant systemic treatment (NST) on postoperative complications and the beginning of adjuvant treatment. Methods: This study includes data from a prospectively maintained database including patients with breast cancer (BC) stage I-IV with or without NST undergoing breast cancer surgery between January 2010 and September 2021. Results: Out of 517 enrolled patients, 77 received NST, 440 had primary breast surgery. After NST patients underwent surgery after a meantime of 34 days (26.5 – 40 days). No statistical significance could be found comparing the complication grading according to the Clavien Dindo classification. The complications were most frequently rated as grade 3b. There were no complications with grade 4 or higher. When differentiating into short and long-term, the overall rate of short-term complications was 20.3% with no significant difference between the two groups (20.8% vs. 20.2%). Regarding long-term complications, there was more impairment of shoulder mobility (26.0% vs. 9.5%, p = < 0.001) and chronic pain (42.9% vs. 28.6%, p = < 0.016) for patients with NST. The beginning of the administration of the adjuvant treatment was comparable in both groups (46.3 days vs. 50.5 days). Conclusion: In our cohort, complications between both groups were comparable according to Clavien Dindo. This study shows that NST has no negative impact on postoperative short-term complications and most importantly did not lead to a delay of the beginning of adjuvant treatment. Therefore, NST can be safely admitted, even when followed by extensive breast reconstruction surgery.

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Section: Interval Between Nst and Surgerymentioning

confidence: 99%

The Impact of Neoadjuvant Systemic Treatment on Postoperative Complications in Breast Cancer Surgery

Maggi

Nussbaumer

Castrezana

et al. 2022

Preprint

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“…Six studies evaluated expander or implant-based reconstructions. 6,22,24,26,29,30 Three studies included both expander or implant-based and autologous, 5,23,25 Volume 152, Number Eight studies used the BREAST-Q of which different domains were selected, five studies used another questionnaire. Studies had a mean follow-up time starting from 6 months after surgery.…”

Section: Study Characteristicsmentioning

confidence: 99%

Quality of life, patient satisfaction, and complications after nipple-sparing versus skin-sparing mastectomy followed by immediate breast reconstruction. A systematic review and meta-analysis.

Clarijs

Peeters

Dongen

et al. 2023

Plastic &Amp; Reconstructive Surgery

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Background: Nipple-sparing mastectomy (NSM) has emerged as an alternative procedure for skin-sparing mastectomy (SSM), followed by immediate breast reconstruction. Because oncologic safety appears similar, patient-reported outcomes (PROs) and complication risks may guide decision-making in individual patients. Therefore, the aim of this systematic review was to compare PROs and complication rates after NSM and SSM. Methods: A systematic literature review evaluating NSM versus SSM was performed using the Embase, MEDLINE, and Cochrane databases. Methodologic quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Form for Cohort Studies. Primary outcomes were PROs and complications. Studies that evaluated BREAST-Q scores were used to perform meta-analyses on five BREAST-Q domains. Results: Thirteen comparative studies including 3895 patients were selected from 1202 articles found. Meta-analyses of the BREAST-Q domains showed a significant mean difference of 7.64 in the Sexual Well-being domain (P = 0.01) and 4.71 in the Psychosocial Well-being domain (P = 0.03), both in favor of NSM. Using the specifically designed questionnaires, no differences in overall satisfaction scores were found. There were no differences in overall complication rates between the two groups. Conclusions: Patient satisfaction scores were high after both NSM and SSM; however, NSM led to a higher sexual and psychosocial well-being. No differences in complication rates were found. In combination with other factors, such as oncologic treatments, complication risk profile, and fear of cancer recurrence, the decision for NSM or SSM has to be made on an individual basis and only if NSM is considered to be oncologically safe.

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“… 32 In one study, physical and psychosocial well-being scores were significantly higher in older women compared to younger age group for both conventional surgical techniques and oncoplastic surgeries. 33 …”

Section: Surgerymentioning

confidence: 99%

Breast Cancer in Geriatric Patients: Current Landscape and Future Prospects

Abdel‐Razeq¹,

Rous²,

Abuhijla³

et al. 2022

CIA

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Breast cancer is the most common cancer diagnosed among women worldwide and more than half are diagnosed above the age of 60 years. Life expectancy is increasing and the number of breast cancer cases diagnosed among older women are expected to increase. Undertreatment, mostly due to unjustifiable fears of advanced-age and associated comorbidities, is commonly practiced in this group of patients who are under-represented in clinical trials and their management is not properly addressed in clinical practice guidelines. With modern surgery and anesthesia, breast surgeries are considered safe and is usually associated with very low complication rates, regardless of extent of surgery. However, oncoplastic surgery and management of the axilla can be tailored based on patients'-and disease-related factors. Most of chemotherapeutic agents, along with targeted therapy and anti-Human epidermal growth factor receptor-2 (HER2) drugs can be safely given for older patients, however, dose adjustment and close monitoring of potential adverse events might be needed. The recently introduced cyclin-D kinase (CDK) 4/6-inhibitors in combination with aromatase inhibitors (AI) or fulvestrant, which changed the landscape of breast cancer therapy, are both safe and effective in older patients and had substituted more aggressive and potentially toxic interventions. Despite its proven efficacy, adjusting or even omitting adjuvant radiation therapy, at least in low-risk older patients, is safe and frequently practiced. In this paper, we review existing data related to breast cancer management among older patients across the continuum; from resection of the primary tumor through adjuvant chemotherapy, radiation and endocrine therapy up to the management of recurrent and advanced-stage disease.

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The impact of age on patient-reported outcomes after oncoplastic versus conventional breast cancer surgery

Cited by 17 publications

References 27 publications

The Impact of Neoadjuvant Systemic Treatment on Postoperative Complications in Breast Cancer Surgery

The Impact of Neoadjuvant Systemic Treatment on Postoperative Complications in Breast Cancer Surgery

Quality of life, patient satisfaction, and complications after nipple-sparing versus skin-sparing mastectomy followed by immediate breast reconstruction. A systematic review and meta-analysis.

Breast Cancer in Geriatric Patients: Current Landscape and Future Prospects

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