Influence of multidisciplinary teams (MDT) on breast satisfaction and sexual well-being in the immediate postoperative phase following breast-conserving surgery (BCS).
Authors: Lee Yi , Aldecoa Kim Abbegail Tan , Briefs-Ferris Andrea , Tsukan Myroslava , Orejuela Jennifer , Mohammad Jani Asad , Cherry Garrett , Tareen Fariha , Golston Victoria , Cooper Oluwatosin , Deptula Lisa , Mbionwu Chioma S. , Eto Ewomamobuho , Krishnamoorthy Geetha , Kirby Amy , Goodman Judie R. 
Published: July 2024

e13788

Background: Despite the recognized significance of multidisciplinary team (MDT) on patient satisfaction post-operatively, limited data exists on its overall impact. This study assessed the impact of MDT, including the surgeon, medical oncologist, and office staff, on patient breast satisfaction and sexual well-being among early-stage breast cancer patients. We examine three early time points after breast-conserving surgery (BCS): 2 weeks, 4 weeks, and 3 months. In addition, demographic and socioeconomic factors affecting patient satisfaction were also analyzed. Methods: A survey using BREAST-Q modules was conducted via telephone interviews among early-stage breast cancer patients who had BCS at a university-affiliated community hospital from October 2022 to September 2023. BREAST-Q responses were translated to Rasch scores (0=lowest, 100=highest). Patient-reported concerns were collected with open-ended questions. The correlation between variables was measured using Pearson’s correlation. A comparison of Rasch scores over time was done with repeated measures of ANOVA. SPSS 28.0 was used for statistical analysis, with a p-value<0.05 considered statistically significant. Results: Of 200 patients assessed, 61 met the study criteria, and 30 participated (mean age 66.3 years±9.9). Most were White (90%), married (55%), with stage 1 cancer (63%) and comorbidities (60%). At 2 weeks, the mean breast satisfaction score was 66.8, which increased to 71.0 at 4 weeks and 88.1 at 3 months (p<0.05), while sexual well-being remained stable (69.0 at 2 weeks, 73.1 at 4 weeks, and 68.3 at 3 months, p>0.05). Pain at the surgical site was the most cited concern at 2 and 4 weeks (30% and 41%, respectively), while dry skin (25%) was the top concern at 3 months. High patient satisfaction scores with the surgeon (mean 95.5), medical team (mean 98.3), and office staff (mean 99.3) were noted throughout the three time periods (p>0.05). Satisfaction with the surgeon was associated with better breast satisfaction and higher sexual well-being scores at two weeks after BCS (p<0.05). No other significant correlations were found between the influence of MDT on patient satisfaction at 4 weeks and 3 months. In a univariate analysis, widows reported the highest breast satisfaction at 2 weeks (94.0, p<0.05). White patients had a higher sexual well-being score than Black patients (72.4 vs. 51.5, p<0.05), while alcohol use had lower sexual well-being scores at 2 weeks (62.5 vs. 89.8, p<0.05). In a multivariable analysis, only marital status and alcohol use remained significant at 2 weeks post-BCS (p<0.05). Conclusions: The study highlights the surgeon’s critical role in achieving high level of patient satisfaction with their breasts and sexual well-being after BCS. Additionally, it reveals the significant influence of sociodemographic factors on patient outcomes.