- 作者：Christine E. Hill-Kayser ; M.D.&lowast ; ; hill@uphs.upenn.edu ; Carolyn Vachani ; M.S.N. ; R.N. ; A.O.C.N.&dagger ; ; Margaret K. Hampshire ; R.N. ; B.S.N. ; O.C.N.&dagger ; ; Gloria A. Di Lullo ; M.S.N. ; C.R.N.P.&dagger ; ; James M. Metz ; M.D.&lowast ;
- 关键词：Breast conserving treatment ; Cosmesis ; Radiation complications ; Late effects after breast cancer ; Patient-reported outcomes
- 刊名：International Journal of Radiation Oncology*Biology*Physics
- 出版年：2012
- 期刊代码：136_03603016
- 类别：med
- 出版时间：1 July, 2012
- 卷：83
- 期：3
- 页码：839-844
- 文件大小：188 K
Purpose
Over the past 30 years, much work in treatment of breast cancer has contributed to improvement of cosmetic and functional outcomes. The goal of breast-conservation treatment (BCT) is avoidance of mastectomy through use of lumpectomy and adjuvant radiation. Modern data demonstrate 鈥渆xcellent鈥?or 鈥済ood鈥?cosmesis in >90%of patients treated with BCT.Methods and Materials
Patient-reported data were gathered via a convenience sample frame from breast cancer survivors using a publically available, free, Internet-based tool for creation of survivorship care plans. During use of the tool, breast cancer survivors are queried as to the cosmetic appearance of the treated breast, as well as perceived late effects. All data have been maintained anonymously with internal review board approval.
Results
Three hundred fifty-four breast cancer survivors having undergone BCT and voluntarily using this tool were queried with regard to breast cosmesis and perceived late effects. Median diagnosis age was 48 years, and median current age 52 years. 鈥淓xcellent鈥?cosmesis was reported by 27%(n = 88), 鈥淕ood鈥?by 44%(n = 144), 鈥淔air鈥?by 24%(n = 81), and 鈥淧oor鈥?by 5%(n = 18). Of the queries posted to survivors after BCT, late effects most commonly reported were cognitive changes (62%); sexual concerns (52%); changes in texture and color of irradiated skin (48%); chronic pain, numbness, or tingling (35%); and loss of flexibility in the irradiated area (30%). Survivors also described osteopenia/osteoporosis (35%), cardiopulmonary problems (12%), and lymphedema (19%).
Conclusions
This anonymous tool uses a convenience sample frame to gather patient reported assessments of cosmesis and complications after breast cancer. Among the BCT population, cosmetic assessment by survivors appears less likely to be 鈥渆xcellent鈥?or 鈥済ood鈥?than would be expected, with 30%of BCT survivors reporting 鈥渇air鈥?or 鈥減oor鈥?cosmesis. Patient reported incidence of chronic pain, as well as cognitive and sexual changes, also appears higher than expected.