scholarly journals Breast cancer patient-reported outcome of factors influencing cosmetic satisfaction after breast-conserving therapy

Breast Cancer ◽  
2021 ◽  
Author(s):  
A. T. P. M. Brands-Appeldoorn ◽  
A. J. G. Maaskant-Braat ◽  
L. Janssen ◽  
L. A. D. M. van Osch ◽  
V. C. G. Tjan-Heijnen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Image ◽  
Breast Surgery ◽  
Breast Conserving Therapy ◽  
Patient Reported Outcome ◽  
Breast Size ◽  
Exclusion Criteria ◽  
Non Invasive ◽  
Patient Reported ◽  
Relevant Factors

Abstract Background The aim of this study was to investigate which factors patients considered to be important for determining the degree of cosmetic satisfaction with regards to perceived body image after previous breast-conserving therapy (BCT). Methods Outcomes considered relevant by the patients were first identified using interviews. A questionnaire based on this group input was then devised and added to the physician-based Sneeuw questionnaire. Next, a quantitative study using this questionnaire was conducted in Dutch patients treated at least 6 months earlier for (non-) invasive breast cancer by BCT. Exclusion criteria were: previous mastectomy or BCT of the contralateral breast, BCT with nipple resection, metastatic disease, local recurrence or (previous) plastic breast surgery. Descriptive statistics were used throughout. Results A total of 149 patients (aged 36–87 years) completed the questionnaire. From this focus group input, the top three factors in overall importance (important or very important) for satisfaction were: ‘wearability of bra’ (67%), ‘breast sensitivity’ (59%) and ‘asymmetry’ (51%). Younger patients (< 55 years) considered ‘breast size’ to be most important, whereas ‘wearability of bra’ was most frequently reported by older patients (> 55 years). Time since BCT did not significantly influence the rating of relevant factors. Conclusion Patients consider ‘wearability of bra’, ‘breast sensitivity’ and ‘asymmetry’ as the most important factors when assessing their satisfaction with regards to cosmetic outcome and body image. These factors should be addressed in routine clinical practice during (pre) counseling.

Quality of Patient-Reported Outcome Studies Utilizing the BREAST-Q: A Systematic Review

2021 ◽  
Author(s):  
Lior Har-Shai ◽  
Sar-El Ofek ◽  
Addy Brandstetter ◽  
Keren H Cohen ◽  
Tamir Shay ◽  
...  
Keyword(s):  
Systematic Review ◽  
Plastic Surgery ◽  
Survey Research ◽  
Breast Surgery ◽  
Sample Size Calculation ◽  
Patient Reported Outcome ◽  
Validated Questionnaire ◽  
Patient Reported ◽  
Current Guidance

Abstract Background Patient-reported outcome (PRO) studies are essential the assessment of surgical procedures in plastic surgery. An accepted and validated questionnaire is the Breast-Q. Objectives This study aims to assess the quality of PRO studies in plastic surgery utilizing the Breast-Q questionnaire. Methods This study included two steps: (1) A systematic review of 23 key-criteria assessing the quality of survey-research in studies utilizing the Breast-Q which were published between 2015-2018; (2) Review of current guidance for survey-research in journals related to Plastic Surgery and Breast Surgery which were included in the systematic review. Results 79 studies were included in the systematic review. Many key-criteria were poorly reported: 51.9% of the studies did not provide a defined response rate and almost 90% did not provide a method for analysis of non-response error. 67.1% lacked a description of the sample's representativeness of the population of interest, and 82.3% did not present a sample size calculation. 11.4% of papers failed to describe the data analyzing methods; in 27.8% the data analysis which was presented could not allow replication of the results. Of the 16 journals in Plastic Surgery and Breast Surgery that their "Instruction to Authors" were reviewed, 15 (93.7%) did not provide any guidance for survey reporting. Conclusions The majority of key criteria are under-reported by authors publishing their survey-research in peer-reviewed journals in the fields of plastic and breast surgery. There is an urgent need for constructing a well-developed reporting guideline for survey-research in plastic surgery and particularly in breast surgery.

Targeted breast surgery: Non-direct approach.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e12602-e12602
Author(s):  
Peter Kern ◽  
Alina Kessel ◽  
Oliver Hoffmann ◽  
Ann-Kathrin Bittner ◽  
Rainer Kimmig
Keyword(s):  
Breast Cancer ◽  
Mammary Gland ◽  
Neoadjuvant Chemotherapy ◽  
Breast Surgery ◽  
Intraoperative Ultrasound ◽  
Direct Approach ◽  
Aesthetic Result ◽  
Stage Distribution ◽  
Tumor Stages ◽  
Patient Reported

e12602 Background: Breast conserving surgery is the standard in T1-T3 primary breast cancer. The cosmetic result is very much depending upon the surgeon ́s experience, the tumor-size/breast ratio and the technique applied. We have proposed a nomogram earlier (1) which has been cited earlier by the American Society of Breast Surgeons Consensus Conference as a concept for avoidance of re-excisions and achievement of a favorable aesthetic result. Our nomogram proposed 5 simple oncoplastic techniques to handle the vast majority of breast cancer cases, with high rates of free margins. However, these techniques all used direct access to the mammary gland through the skin above the tumor, leaving permanent scars in the visible skin of the breast. To avoid this, we now have chosen a more natural access to the mammary gland along natural transitions and Langerhans´s skin lines in this prospective open-label study. Methods: We conducted a prospective open-arm study including all primary invasive and non-invasive breast cancer cases of tumor stages AJCC 0-III A (Version 8.0). Non-palbable tumors and those undergoing neoadjuvant chemotherapy had to be marked by a wire and clipped before. Intraoperative ultrasound was applied before skin incision and after removal of the tumor including ultrasound of the specimen to confirm clear margins). Resection was performed as a segmentectomy and SLN biopsy and axillary clearance was done according to national guidelines. Access to the tumor was chosen in a non-direct approach according to the proximity of the tumor to one of the following natural transitions: 1. areola 2. axillary line 3. inframammary fold. Results: 84 patients with breast conserving targeted breast surgery with a "non-direct to the tumor approach" have been enrolled so far. 76 patients had primary surgery with stage distribution as follows: Tis (1), T1a (3), T1b (8), T1c (30), T2 (30), T3 (4) and T4b(1). 8 patients had neoadjuvant chemotherapy with stage distribution as follows: ypT0 (3), ypT1a (2), ypT1c (1) and ypT2 (2). Histopathology was predominantly invasive-ductal breast cancer (70), followed by invasive-lobular (6), ductulo-lobular (5), invasive- ductal and pure DCIS (1), invasive-ductal and mucinous (1) and mucinous only (1). After first surgery according to our nomogram 77 patients had a tumor resection with free margins and 7 with involved margins, thus 91,6 % tumors were resected with free margins at first surgery. The remaining 8,4 % of cases were margin-free after second surgery. Conclusions: Scars were not visible on the surface of the breast outside of natural transitions and rate of free margins was high with targeted breast surgery at a rate of 91,6 % without any cosmetic impairment due to the remote natural access to the mammary gland. Patient-reported outcome in detail has been evaluated by validated questionnaires and demonstrated a high satisfaction with scar pattern, volume and symmetry.

Young, Empowered and Strong: A Web-Based Education and Supportive Care Intervention for Young Women With Breast Cancer Across the Care Continuum

2021 ◽  
pp. 933-943
Author(s):  
Tal Sella ◽  
Craig Snow ◽  
Hannah Freeman ◽  
Philip D. Poorvu ◽  
Shoshana M. Rosenberg ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Young Women ◽  
Breast Cancer Survivors ◽  
Metastatic Breast ◽  
Patient Reported Outcome ◽  
Self Management ◽  
Semistructured Interview ◽  
Web Based ◽  
Care Continuum ◽  
Patient Reported

PURPOSE Patient-centered digital interventions may help empower young women to self-manage symptoms and psychosocial concerns and support informational needs often unaddressed in clinic. METHODS Young, Empowered and Strong (YES) is an interactive web-based intervention designed to engage young women with personalized education and symptom self-management resources on the basis of responses to patient-reported outcome–based questionnaires. We piloted YES among young women (< 45 years) with newly diagnosed early breast cancer (EBC) or metastatic breast cancer (MBC) and breast cancer survivors (BCSs). Assessments were deployed weekly (EBC and MBC) or every 4 weeks (BCSs) over 12 weeks. At study completion, use, feasibility, and acceptability of YES were evaluated via a survey and semistructured interview. RESULTS Thirty women were enrolled between April and June 2019: 10 EBC, 10 BCSs, and 10 MBC. The mean age at diagnosis and enrollment was 36 (range 25-44) and 39 (range 31-44) years, respectively. Most participants were actively treated (96%, 27 of 28) with endocrine therapy (54%, 15 of 28) or chemotherapy (43%, 12 of 28). Overall, 61% (180 of 296) of assessments were completed (EBC: 70%, BCSs: 63%, and MBC: 52%). Of 37 patient-reported outcome and need domains, the most frequently triggered were sexual health (EBC: 90%, BCSs: 90%, and MBC: 90%), anxiety (EBC: 80%, BCSs: 90%, and MBC: 90%), stress and mindfulness (EBC: 80%, BCSs: 90%, and MBC: 90%), and fatigue (EBC: 90%, BCSs: 80%, and MBC: 90%). On postpilot survey, participants reported that YES helped them to learn (50%, 7 of 14), monitor (43%, 6 of 14), and manage (57%, 8 of 14) their symptoms. CONCLUSION YES is a feasible and acceptable digital intervention to support young women across the breast cancer care continuum. The nearly universal triggering of sexual and mental health needs suggests suboptimal management in the clinical setting and the potential for self-management through a digital platform.

Factors related to patient-reported cosmetic outcome after breast-conserving therapy for breast cancer

2021 ◽  
Author(s):  
A. T. P. M. Brands-Appeldoorn ◽  
R. C. M. Thomma ◽  
L. Janssen ◽  
A. J. G. Maaskant-Braat ◽  
V. C. G. Tjan-Heijnen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Conserving Therapy ◽  
Cosmetic Outcome ◽  
Patient Reported

scholarly journals Short-term serial assessment of electronic patient-reported outcome for depression and anxiety in breast Cancer

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jeeyeon Lee ◽  
Jin Hyang Jung ◽  
Wan Wook Kim ◽  
Byeongju Kang ◽  
Jungmin Woo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Treatment Period ◽  
Depression Scale ◽  
Patient Reported Outcome ◽  
Depression And Anxiety ◽  
Short Term ◽  
Web Based ◽  
Patient Reported ◽  
Patient Health

Abstract Purpose The incidence of depression and anxiety is higher in patients with breast cancer than in the general population. We evaluated the degree of depression and anxiety and investigated the changes in patients with breast cancer during the treatment period and short-term follow-up period. Methods Overall, 137 patients with breast cancer were evaluated using the Patient Health Questionnaire 9-item depression scale (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7). The scales were developed as a web-based electronic patient-reported outcome measure, and serial results were assessed before the operation, after the operation, in the post-treatment period, and in the 6-month follow-up period after surgery. Results The degree of depression and anxiety increased during treatment and decreased at 6-month follow-up, even if there were no statistical differences among the four periods (PHQ-9: p = 0.128; GAD-7: p = 0.786). However, daily fatigue (PHQ-9 Q4) and insomnia (PHQ-9 Q3) were the most serious problems encountered during treatment and at 6-month follow-up, respectively. In the GAD-7, worrying too much (Q3) consistently showed the highest scores during the treatment and follow-up periods. Of the patients, 7 (5.11%) and 11 (8.03%) patients had a worsened state of depression and anxiety, respectively, after treatment compared with before treatment. Conclusion Most factors associated with depression and anxiety improved after treatment. However, factors such as insomnia and worrying too much still disturbed patients with breast cancer, even at 6-month follow-up. Therefore, serial assessment of depression and anxiety is necessary for such patients.

scholarly journals Patient-Reported Outcome Measures May Add Value in Breast Cancer Surgery

2018 ◽  
Vol 25 (12) ◽  
pp. 3563-3571 ◽  
Author(s):  
M. Lagendijk ◽  
L. S. E. van Egdom ◽  
F. E. E. van Veen ◽  
E. L. Vos ◽  
M. A. M. Mureau ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Outcome Measures ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Cancer Surgery ◽  
Breast Cancer Surgery ◽  
Patient Reported
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