Avaliação dos resultados estéticos e de qualidade de vida em pacientes submetidas à mastectomia com reconstrução mamária imediata com prótese e simetrização da mama contralateral concomitante

• Autor(a) principal: Kuroda, Flávia
• Data de Publicação: 2015
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório do Centro Universitário Braz Cubas
• Texto Completo: https://repositorio.cruzeirodosul.edu.br/handle/123456789/2592
• topic: Câncer de mama; Estética; Reconstrução com prótese; CNPQ::CIENCIAS BIOLOGICAS::BIOLOGIA GERAL

Background: Immediate breast reconstruction using implants is considered to be one of the most important improvements concerning breast cancer surgery. Today, it is the most widely form of breast reconstruction in breast cancer patient. Recent emphasis on women’s quality of life following breast cancer treatment has drawn attention to the importance of aesthetic outcome and potential benefits of immediate breast reconstruction. The present study aimed to assess and compare the aesthetic and life quality outcomes in breast cancer patients undergoing mastectomy with immediate breast reconstruction using implant and contralateral breast symmetrization. Methods: 129 patients were included in this cross-sectional multicentric study; 94 (72,8%) underwent mastectomy with immediate breast reconstruction using implant and contralateral breast symmetrization, and 35 (27,1%) to mastectomy alone. The aesthetic results were evaluated only at IBR with implant group by 3 different methods: the patients self-report, assessment of 4 specialists (two breast surgeons and two plastic surgeons from different institutions) using the Garbay scale and BCCT.core software. Quality of life was evaluated in both group through 2 questionnaries: a generic self-report SF-36 and a specific patient- reported outcome instrument breast reconstruction postoperative module – Breast-Q. Results: Patients in the IBR with implant group had a significantly higher proportion of excellent and good aesthetic results (92,3%) comparing with the software (71,1%) and the specialists (73,1%)(p<0,001). There was no significant difference in the comparison between software and specialist´s evaluation. Multifactorial analyses showed that age >70 years (p=0,015) and radiotherapy (p>0,001) where significant risk factors for poor aesthetic outcomes after IBR with implant. Considering quality of life using SF-36 questionnarie, there was a significant difference (p<0,05) between the groups with higher values observed in the reconstruction group in physical functioning (p=0,012), role physical (p=0,004), pain (p=0,024), health perception (p=0,024) and social functioning (p=0,002). In the Breast-Q evaluation, the IBR group was associated with higher scores in satisfaction with breast (p<0,001), psycho-social well-being (p<0,001) and sexual well-being (p<0,001). Conclusion: IBR with implant had a positive impact in quality of life when comparing with mastectomy alone. Excellent and goof aesthetic results were more frequent in patients evaluation than by software and specialists. Some clinical conditions like age and radiotherapy can be considered as risky factors for poor aesthetic outcomes in IBR with implants. So, IBR with implants showed satisfactory outcomes when evaluated by subjective and objective analyses