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Satisfação e qualidade de vida após terapêutica cirúrgica do cancro da mama
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Introdução: O cancro da mama na mulher é a neoplasia de maior incidência a nível mundial, com mortalidade a diminuir nos países desenvolvidos. Com o aumento da sobrevivência, passou a dar-se mais importância à satisfação e qualidade de vida após terapêutica cirúrgica do cancro da mama. O presente trabalho surge neste contexto, com o objetivo de avaliar a satisfação com as mamas e a qualidade de vida de sobreviventes do cancro da mama após terapêutica cirúrgica. Adicionalmente, foi investigada a existência de variáveis independentes com impacto sobre os outcomes referidos. Metodologia: Este estudo, observacional analítico transversal, incluiu 54 doentes submetidas a cirurgia conservadora da mama ou a mastectomia com reconstrução mamária (imediata/diferida, com prótese + ADM/RGD). Para o efeito, foram utilizados dois PROMs (BREAST-Q© e uma adaptação do WHOQOL-BREF), preenchidos no período pós-cirúrgico. As respostas foram analisadas e correlacionadas com informação clínica recolhida a partir do processo de cada doente. Resultados: Um total de 32 doentes submetidas a tumorectomia e de 22 doentes submetidas a mastectomia com reconstrução mamária responderam aos questionários, com uma mediana e variação interquartil de 30 (11 – 59) meses pós-cirurgia. A mediana da “satisfação com as mamas” foi de 75,0% e 75,8% e a mediana da “qualidade de vida” foi de 77,1% e 82,9%, respetivamente. Na análise univariada, apenas a simetrização da mama contralateral apresentou uma associação estatisticamente significativa com o score de qualidade de vida (p=0,038). Avançou-se para uma análise multivariada, que não identificou variáveis independentes (p=0,064). Conclusão: As participantes deste estudo estão globalmente satisfeitas com as suas mamas e autoavaliam a sua qualidade de vida após terapêutica cirúrgica do cancro da mama como boa. É de reforçar a necessidade de mais investigação nesta área, de forma a reduzir a morbilidade associada à terapêutica e possibilitar uma melhor e mais adequada prestação de cuidados de saúde.
Introduction: Breast cancer in women is the highest incidence cancer worldwide, with decreasing mortality in developed countries. With an increase in survival, more importance has been given to satisfaction and quality of life after surgical treatment of breast cancer. This study aimed to evaluate breast cancer survivors' satisfaction with breasts and quality of life after surgical treatment. Additionally, the existence of independent variables with an impact on the outcomes was investigated. Methodology: This cross-sectional study included 54 patients undergoing breast conserving surgery or mastectomy and breast reconstruction (immediate/delayed, with implant + acellular dermal matrix/latissimus dorsi musculocutaneous flap). For this purpose, two PROMs (BREAST-Q© and a WHOQOL-BREF adaptation) were used and filled in post-operatively. The responses were analyzed and correlated with clinical information collected from each patient’s process. Results: A total of 32 patients who underwent breast-conserving surgery and 22 patients with mastectomy and breast reconstruction answered the questionnaires, with a median and interquartile range of 30 (11 – 59) months after surgery. The median of "satisfaction with breasts" was 75,0% and 75,8% and the median of "quality of life" was 77,1% and 82,9%, respectively. In the univariate analysis, only contralateral breast symmetrization showed a statistically significant association with the quality of life score (p=0,038). A multivariate analysis was performed, with no independent variables identified (p=0,064). Conclusions: Participants in this study were globally satisfied with their breasts and self assessed their quality of life after breast cancer surgery as good. The need for further research in this area should be reinforced to reduce therapy-related morbidity and enable better and more appropriate healthcare delivery.
Introduction: Breast cancer in women is the highest incidence cancer worldwide, with decreasing mortality in developed countries. With an increase in survival, more importance has been given to satisfaction and quality of life after surgical treatment of breast cancer. This study aimed to evaluate breast cancer survivors' satisfaction with breasts and quality of life after surgical treatment. Additionally, the existence of independent variables with an impact on the outcomes was investigated. Methodology: This cross-sectional study included 54 patients undergoing breast conserving surgery or mastectomy and breast reconstruction (immediate/delayed, with implant + acellular dermal matrix/latissimus dorsi musculocutaneous flap). For this purpose, two PROMs (BREAST-Q© and a WHOQOL-BREF adaptation) were used and filled in post-operatively. The responses were analyzed and correlated with clinical information collected from each patient’s process. Results: A total of 32 patients who underwent breast-conserving surgery and 22 patients with mastectomy and breast reconstruction answered the questionnaires, with a median and interquartile range of 30 (11 – 59) months after surgery. The median of "satisfaction with breasts" was 75,0% and 75,8% and the median of "quality of life" was 77,1% and 82,9%, respectively. In the univariate analysis, only contralateral breast symmetrization showed a statistically significant association with the quality of life score (p=0,038). A multivariate analysis was performed, with no independent variables identified (p=0,064). Conclusions: Participants in this study were globally satisfied with their breasts and self assessed their quality of life after breast cancer surgery as good. The need for further research in this area should be reinforced to reduce therapy-related morbidity and enable better and more appropriate healthcare delivery.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2023
Palavras-chave
Cancro da mama Terapêutica cirúrgica Satisfação com as mamas Qualidade de vida