A comparative study on quality of life of patients with breast cancer receiving subcutaneous gland resection combined with primary prosthesis implantation: Minimally invasive versus open surgery.
Authors: Wan Andi , Zhou Yuqin , Zhang Cong , Qu Man , Ma Jing , Bao Yangqiu , Wang Yinhuan , Wang Benqiong , Wang Yan , Wang Shushu , Tang Peng , Liang Yan , Chen Li , Zhong Ling , Liu Junlan , Liu Cong , Jiang Jun , Zhang Yi , Qi Xiaowei 
Published: July 2024

e12597

Background: Subcutaneous gland resection of the breast combined with primary prosthesis reconstruction is mostly used for reconstruction of early breast cancer (EBC) patients. In this study, we compared the long-term quality of life (QOL) of patients who underwent these procedures in a minimally invasive or open approach. Methods: The baseline data of EBC patients who underwent subcutaneous gland resection of breast combined with primary prosthesis reconstruction in a minimally invasive or open approach from 2008 to 2020 were retrospectively analyzed. The patients receiving minimally invasive surgery were regarded as minimally invasive group, and open surgery were regarded as open group. The BREAST-Q questionnaires were used to evaluate patients’ satisfaction with breasts, implants, animation deformity, psychosocial well-being, sexual well-being, physical well-being (chest) and breast sensation. Results: A total of 546 patients were enrolled, patients with local and regional recurrence, distant metastasis, death and prosthesis (44, 44, 22,12, respectively) were excluded, 423 patients were given questionnaires to evaluate their quality of life. Totally 226 questionnaires were recovered, with a response rate of 53.43%. Except 5 questionnaires with incomplete answers, 221 questionnaires were finally valid. There were 105 cases in the minimally invasive group, with an average follow-up time of 107.48 months (range 39-185 months), and 115 cases in the open group, with an average follow-up time of 77.97 months (range 36-188 months). The age was 43.0 [37.0, 47.0] years in all patients, 43.0[38.0, 47.0] years in the minimally invasive group and 42.5[36.8, 47.0] years in the open group. The patients in stage T1-2 accounted for 96.19% in the minimally invasive group and 97.42% in the open group, stage N0-1 accounted for 90.48% and 93.97, respectively. Prosthetic implant size showed no significant difference between two groups (220 [180, 240] cm3 vs 200 [180, 245] cm3, p=0.083). No significant difference was observed in patients’ race, education, marital status, income, job and breast size between the two groups ( p>0.05). The scores of the minimally invasive group in satisfaction with breasts (54.0 [47.0, 59.0] vs 49.0 [44.8, 55.0], p<0.01), animation deformity (70.0 [59.0, 100.0] vs 62.0 [57.0, 84.0], p=0.016), psychosocial well-being (66.0 [53.0, 93.0] vs 62.0 [49.0, 83.0], p=0.027), and physical well-being(chest) (48.0 [32.0, 56.0] 42.0 vs [32.0, 52.0], p=0.038) were significantly higher compared with the open group. There was no significant difference in implants, sexual well-being and breast sensation between the two groups. Conclusions: Minimally invasive subcutaneous gland resection combined with primary prosthetic implantation may improve postoperative quality of life in patients with EBC.