The impact of age on patient-reported outcomes after oncoplastic versus conventional breast cancer surgery

M Haug,S D Soysal,J Lévy,L Zehnpfennig,M Müller,W P Weber,B M Ling,E A Kappos,G Montagna,L López Castrezana,F D Schwab,M Ritter,C Kurzeder,I Oberhauser

doi:10.1007/s10549-021-06126-6

Abstract

PurposeSome studies have indicated age-specific differences in quality of life (QoL) among breast cancer (BC) patients. The aim of this study was to compare patient-reported outcomes after conventional and oncoplastic breast surgery in two distinct age groups.MethodsPatients who underwent oncoplastic and conventional breast surgery for stage I-III BC, between 6/2011–3/2019, were identified from a prospectively maintained database. QoL was prospectively evaluated using the Breast-Q questionnaire. Comparisons were made between women < 60 and ≥ 60 years.ResultsOne hundred thirty-three patients were included. Seventy-three of them were ≥ 60 years old. 15 (20.5%) of them received a round-block technique (RB) / oncoplastic breast-conserving surgeries (OBCS), 10 (13.7%) underwent nipple-sparing mastectomies (NSM) with deep inferior epigastric perforator flap (DIEP) reconstruction, 23 (31.5%) underwent conventional breast-conserving surgeries (CBCS), and 25 (34.2%) received total mastectomy (TM). Sixty patients were younger than 60 years, 15 (25%) thereof received RB/OBCS, 22 (36.7%) NSM/DIEP, 17 (28.3%) CBCS, and 6 (10%) TM. Physical well-being chest and psychosocial well-being scores were significantly higher in older women compared to younger patients (88.05 vs 75.10; p < 0.001 and 90.46 vs 80.71; p = 0.002, respectively). In multivariate linear regression, longer time intervals had a significantly positive effect on the scales Physical Well-being Chest (p = 0.014) and Satisfaction with Breasts (p = 0.004). No significant results were found concerning different types of surgery.ConclusionOur findings indicate that age does have a relevant impact on postoperative QoL. Patient counseling should include age-related considerations, however, age itself cannot be regarded as a contraindication for oncoplastic surgery.

Highlights

Over the last decades, significant improvements have been made in the treatment of breast cancer (BC), resulting in improved survival rates, especially in early-stage disease [1]
Women were eligible for study inclusion if they underwent either conventional surgical techniques, such as total mastectomy (TM) and conventional breast-conserving surgeries (CBCS), or oncoplastic breast-conserving surgeries (OBCS), roundblock technique (RB) or nipple-sparing mastectomy (NSM) with deep inferior epigastric perforator flap (DIEP) reconstruction
The group of older patients consisted of 73 patients: 15 (20.5%) of them underwent round-block technique (RB)/OBCS, 10 (13.7%) nipplesparing mastectomies (NSM) with DIEP reconstruction, 23 (31.5%) CBCS, and 25 (34.2%) TM

Summary

Introduction

Significant improvements have been made in the treatment of breast cancer (BC), resulting in improved survival rates, especially in early-stage disease [1]. Since BC can affect different age groups, it seems important to examine age-related differences in terms of QoL. This might contribute to personalized decision making, taking into account this important variable when counseling our patients. Breast Cancer Research and Treatment (2021) 187:437–446 survivorship exists [2,3,4], only few studies have investigated age-related differences in postoperative QoL, comparing different breast surgery procedures [5, 6]. The aim of this study was to compare QoL in two distinct age groups after conventional and oncoplastic breast surgery using the Breast-Q as validated, patient-reported outcome assessment tool [9,10,11]

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Conclusion