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Scar Wars: Preferences in Breast Surgery

  • Joyce, Cormac W (Department of Plastic Surgery, University Hospital Galway) ;
  • Murphy, Siun (Department of Plastic Surgery, St Vincent's University Hospital) ;
  • Murphy, Stephen (Department of Plastic Surgery, University Hospital Galway) ;
  • Kelly, Jack L (Department of Plastic Surgery, University Hospital Galway) ;
  • Morrison, Colin M (Department of Plastic Surgery, St Vincent's University Hospital)
  • 투고 : 2015.03.18
  • 심사 : 2015.05.26
  • 발행 : 2015.09.15

초록

Background The uptake of breast reconstruction is ever increasing with procedures ranging from implant-based reconstructions to complex free tissue transfer. Little emphasis is placed on scarring when counseling patients yet they remain a significant source of morbidity and litigation. The aim of this study was to examine the scarring preferences of men and women in breast oncoplastic and reconstructive surgery. Methods Five hundred men and women were asked to fill out a four-page questionnaire in two large Irish centres. They were asked about their opinions on scarring post breast surgery and were also asked to rank the common scarring patterns in wide local excisions, oncoplastic procedures, breast reconstructions as well as donor sites. Results Fifty-eight percent of those surveyed did not feel scars were important post breast cancer surgery. 61% said that their partners' opinion of scars were important. The most preferred wide local excision scar was the lower lateral quadrant scar whilst the scars from the deep inferior epigastric artery perforator (DIEP) flap were most favoured. The superior gluteal artery perforator flap had the most preferred donor site while surprisingly, the DIEP had the least favourite donor site. Conclusions Scars are often overlooked when planning breast surgery yet the extent and position of the scar needs to be outlined to patients and it should play an important role in selecting a breast reconstruction option. This study highlights the need for further evaluation of patients' opinions regarding scar patterns.

키워드

참고문헌

  1. Matros E, Yueh JH, Bar-Meir ED, et al. Sociodemographics, referral patterns, and Internet use for decision-making in microsurgical breast reconstruction. Plast Reconstr Surg 2010; 125:1087-94.
  2. Manderson L, Stirling L. The absent breast: speaking of the mastectomied body. Fem Psychol 2007;17:75-92. https://doi.org/10.1177/0959353507072913
  3. Cocquyt VF, Blondeel PN, Depypere HT, et al. Better cosmetic results and comparable quality of life after skin-sparing mastectomy and immediate autologous breast reconstruction compared to breast conservative treatment. Br J Plast Surg 2003;56:462-70. https://doi.org/10.1016/S0007-1226(03)00198-X
  4. Bartelink H, van Dam F, van Dongen J. Psychological effects of breast conserving therapy in comparison with radical mastectomy. Int J Radiat Oncol Biol Phys 1985;11:381-5. https://doi.org/10.1016/0360-3016(85)90161-0
  5. Lindegren A, Halle M, Docherty Skogh AC, et al. Postmastectomy breast reconstruction in the irradiated breast: a comparative study of DIEP and latissimus dorsi flap outcome. Plast Reconstr Surg 2012;130:10-8.
  6. Gilboa D, Borenstein A, Floro S, et al. Emotional and psychosocial adjustment of women to breast reconstruction and detection of subgroups at risk for psychological morbidity. Ann Plast Surg 1990;25:397-401. https://doi.org/10.1097/00000637-199011000-00008
  7. Abu-Nab Z, Grunfeld EA. Satisfaction with outcome and attitudes towards scarring among women undergoing breast reconstructive surgery. Patient Educ Couns 2007;66:243-9. https://doi.org/10.1016/j.pec.2006.12.008
  8. Lee CN, Hultman CS, Sepucha K. What are patients' goals and concerns about breast reconstruction after mastectomy? Ann Plast Surg 2010;64:567-9.
  9. Joyce CW, Morrison CM, Sgarzani R, et al. Patient preferences in an online breast reconstruction resource. J Plast Reconstr Aesthet Surg 2013;66:e380-1. https://doi.org/10.1016/j.bjps.2013.07.016
  10. Gopie JP, Hilhorst MT, Kleijne A, et al. Women's motives to opt for either implant or DIEP-flap breast reconstruction. J Plast Reconstr Aesthet Surg 2011;64:1062-7. https://doi.org/10.1016/j.bjps.2011.03.030
  11. Alderman AK, Hawley ST, Waljee J, et al. Understanding the impact of breast reconstruction on the surgical decision-making process for breast cancer. Cancer 2008;112:489-94. https://doi.org/10.1002/cncr.23214
  12. Rolnick SJ, Altschuler A, Nekhlyudov L, et al. What women wish they knew before prophylactic mastectomy. Cancer Nurs 2007;30:285-91. https://doi.org/10.1097/01.NCC.0000281733.40856.c4
  13. Sheehan J, Sherman KA, Lam T, et al. Association of information satisfaction, psychological distress and monitoring coping style with post-decision regret following breast reconstruction. Psychooncology 2007;16:342-51. https://doi.org/10.1002/pon.1067
  14. Coutinho M, Southern S, Ramakrishnan V, et al. The aesthetic implication of scar position in breast reconstruction. Br J Plast Surg 2001;54:326-30. https://doi.org/10.1054/bjps.2001.3563
  15. Bailey SH, Saint-Cyr M, Oni G, et al. Aesthetic subunit of the breast: an analysis of women's preference and clinical implications. Ann Plast Surg 2012;68:240-5. https://doi.org/10.1097/SAP.0b013e318216b563
  16. Yueh JH, Slavin SA, Adesiyun T, et al. Patient satisfaction in postmastectomy breast reconstruction: a comparative evaluation of DIEP, TRAM, latissimus flap, and implant techniques. Plast Reconstr Surg 2010;125:1585-95. https://doi.org/10.1097/PRS.0b013e3181cb6351
  17. Kim MS, Rodney WN, Reece GP, et al. Quantifying the aesthetic outcomes of breast cancer treatment: assessment of surgical scars from clinical photographs. J Eval Clin Pract 2011;17:1075-82. https://doi.org/10.1111/j.1365-2753.2010.01476.x
  18. Brolmann FE, Eskes AM, van de Kar AL, et al. Are digital photographs reliable to assess donor site scars? An inter-method analysis and validity testing. J Plast Reconstr Aesthet Surg 2013;66:1632-5. https://doi.org/10.1016/j.bjps.2013.05.005

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