Patient-reported outcomes utilizing the BREAST-Q questionnaire after breast-conserving surgery with and without oncoplastic breast surgery: a systematic review and meta-analysis

Oncoplastic breast surgery (OBS) arose to decrease the deformity following breast-conserving surgery (BCS) for breast cancer. In this meta-analysis (MA), we pool BREAST-Q questionnaire data to compare quality of life (QOL) in breast cancer patients who received BCS alone or in combination with level...

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Hauptverfasser: Panayi, Adriana C. (VerfasserIn) , Knoedler, Samuel (VerfasserIn) , Knoedler, Leonard (VerfasserIn) , Tapking, Christian (VerfasserIn) , Hundeshagen, Gabriel (VerfasserIn) , Diehm, Yannick (VerfasserIn) , Fischer, Sebastian (VerfasserIn) , Thamm, Oliver Christian (VerfasserIn) , Kneser, Ulrich (VerfasserIn) , Haug, Valentin (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: November 2024
In: Aesthetic surgery journal
Year: 2024, Jahrgang: 44, Heft: 11, Pages: NP778-NP789
ISSN:1527-330X
DOI:10.1093/asj/sjae002
Online-Zugang:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1093/asj/sjae002
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Verfasserangaben:Adriana C. Panayi, MD, Samuel Knoedler, Leonard Knoedler, MD, Christian Tapking, MD, MMS, Gabriel Hundeshagen, MD, MMS, Yannick F. Diehm, MD, MMS, Sebastian Fischer, MD, MHBA, Oliver C. Thamm, MD, Ulrich Kneser, MD, and Valentin Haug, MD

MARC

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520 |a Oncoplastic breast surgery (OBS) arose to decrease the deformity following breast-conserving surgery (BCS) for breast cancer. In this meta-analysis (MA), we pool BREAST-Q questionnaire data to compare quality of life (QOL) in breast cancer patients who received BCS alone or in combination with level I or II oncoplastic breast surgery (BCS + OBS). All relevant databases were searched following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) and QUOROM (Quality of Reporting of Meta-Analyses) guidelines. All prospective or retrospective studies with a BCS or BCS + OBS cohort that reported QOL as assessed with the BREAST-Q questionnaire were eligible. Fifty-five studies (75 distinct patient cohorts; 11,186 patients) were included in the MA, with 12 studies reporting both preoperative and postoperative values and eligible for a pair-wise MA. The pair-wise MA showed a significant postoperative improvement in the overall satisfaction with the breast (mean difference [MD] +8.0%, P = .003) and in the psychosocial well-being (MD +9.2%, 3.5-14.8, P = .001) of the entire cohort (BCS and BCS + OBS). A subgroup MA of proportions highlighted a superiority of BCS + OBS to BCS in overall satisfaction with the breast (72.0%, 68.0-76.1, vs 62.9%, 58.3-67.5; P = .02) and psychosocial well-being (78.9%, 71.5-86.4, vs 73.3%, 67.3-76.5, P = .0001). A leave-1-out sensitivity analysis confirmed the results of the pair-wise MA and the MA of proportions. Oncoplastic breast surgery effectively improves QOL and patient satisfaction based on the patient-reported outcomes assessed with the BREAST-Q questionnaire. The improvements were associated with acceptable complication rates, further supporting BCS followed by OBS when mastectomy would otherwise be necessary. 
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