The Impact of Radiotherpay on Long-Term Satisfaction and Health Related Quality of Life in Postmastectomy Breast Reconstruction - An analysis of 3,265 Patients
Jonas Nelson, MD1, Thais Polanco, MD1, Meghana Shamsunder, MPH1, Aadit Patel, MD1, Nikhil Sobti, MS1, Colleen McCarthy, MD1, Evan Matros, MD MMSc MPH1, Joseph Dayan, MD1, Joseph Disa, MD1, Peter Cordeiro, MD1, Andrea Pusic, MD2, Babak Mehrara, MD1, Robert Allen, Jr., MD1.
1Memorial Sloan Kettering Cancer Center, New York, NY, USA, 2Brigham and Women's Hospital, Boston, MA, USA.
Background: This study aims to assess the effects of radiation therapy (XRT) on long-term satisfaction and health related-quality of life in patients undergoing post-mastectomy, implant-based (IBR) or autologous breast reconstruction (ABR).
Methods: BREAST-Q scores for women who underwent IBR or ABR at a tertiary academic cancer center were prospectively collected from 2009 - 2017 as part of routine care. Mean scores for satisfaction with breasts, outcome, and physical well-being of the chest were examined by XRT status, timing, and reconstructive modality preoperatively and at years 1-5 using non-parametric analyses and regression analyses.
Results: Of 3,265 included patients, 867 patients underwent XRT. XRT patients at preoperative timepoints or postoperatively scored significantly lower than non-XRT patients (p < 0.01; Table 1). Patients with XRT had lower physical well-being scores compared to patients without XRT at each postoperative timepoint. ABR patients with XRT had higher breast satisfaction scores than IBR with XRT (p < 0.01; Figure 1).
Conclusion: XRT adversely impacts long-term postoperative breast satisfaction and physical well-being of the chest. This data can improve preoperative counseling for modality decision making, informed consent, and expectation management in patients undergoing breast reconstruction in the setting of XRT.
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