The association between complications and quality of life after mastectomy and breast reconstruction for breast cancer

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dc.contributor.authorBrowne, John P.
dc.contributor.authorJeevan, Ranjeet
dc.contributor.authorGulliver-Clarke, Carmel
dc.contributor.authorPereira, Jerome
dc.contributor.authorCaddy, Christopher M.
dc.contributor.authorvan der Meulen, Jan H. P.
dc.contributor.funderHealthcare Quality Improvement Partnership, United Kingdom
dc.date.accessioned2018-05-11T10:23:59Z
dc.date.available2018-05-11T10:23:59Z
dc.date.issued2017-05-17
dc.date.updated2018-04-27T12:19:27Z
dc.description.abstractBACKGROUND: Medical treatment for breast cancer is associated with substantial toxicity and patient burden. There is less known about the impact of surgical complications. Understanding this impact could provide important information for patients when they are considering surgical options. METHODS: Between 2008 and 2009, the UK National Mastectomy and Breast Reconstruction Audit recorded surgical complications for a prospective cohort of 17,844 women treated for breast cancer at 270 hospitals; 6405 of these women were surveyed about their quality of life 18 months after surgery. Breast appearance, emotional well‐being, and physical well‐being were quantified on 0‐ to 100‐point scales. Linear multiple regression models, controlling for a range of baseline prognostic factors, were used to compare the scores of patients who had complications with the scores of those who did not. RESULTS: The overall complication rate was 10.2%. Complications were associated with little or no impairment in women undergoing mastectomy without reconstruction or with delayed reconstruction. The association was much larger for flap‐related complications suffered during immediate reconstruction. The breast‐appearance scores (adjusted mean difference, –23.8; 95% confidence interval [CI], –31.0 to –16.6) and emotional well‐being scores (adjusted mean difference, –14.0; 95% CI, –22.0 to –6.0) of these patients were much lower than those of any other patient group. Implant‐related complications were not associated with a lower quality of life in any surgical group. CONCLUSIONS: There is a strong case for prospectively collecting flap‐complication rates at the surgeon and surgical unit level and for allowing patients to access these data when they make choices about their breast cancer surgery.en
dc.description.statusPeer revieweden
dc.description.versionAccepted Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationBrowne, J. P., Jeevan, R., Gulliver-Clarke, C., Pereira, J., Caddy, C. M. and van der Meulen, J. H. P. (2017) 'The association between complications and quality of life after mastectomy and breast reconstruction for breast cancer', Cancer, 123(18), pp. 3460-3467. doi:10.1002/cncr.30788en
dc.identifier.doi10.1002/cncr.30788
dc.identifier.endpage3467en
dc.identifier.issn0008-543X
dc.identifier.issued18en
dc.identifier.journaltitleCanceren
dc.identifier.startpage3460en
dc.identifier.urihttps://hdl.handle.net/10468/6082
dc.identifier.volume123en
dc.language.isoenen
dc.publisherJohn Wiley & Sons, Inc.en
dc.rights© 2017, American Cancer Society. All rights reserved. This is the peer reviewed version of the following article: Browne, J. P., Jeevan, R., Gulliver-Clarke, C., Pereira, J., Caddy, C. M. and van der Meulen, J. H. P. (2017) 'The association between complications and quality of life after mastectomy and breast reconstruction for breast cancer', Cancer, 123(18), pp. 3460-3467. doi:10.1002/cncr.30788, which has been published in final form at https://onlinelibrary.wiley.com/doi/abs/10.1002/cncr.30788. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.en
dc.subjectBreast canceren
dc.subjectBreast reconstructionen
dc.subjectMastectomyen
dc.subjectPostoperative complicationsen
dc.subjectQuality of lifeen
dc.titleThe association between complications and quality of life after mastectomy and breast reconstruction for breast canceren
dc.typeArticle (peer-reviewed)en
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