Patient Menopausal Status Effects on Reported Post-Mastectomy BREAST-Q Satisfaction Scores and Potential Underlying Factors that Affect Scores Based on Menopausal Status
Katherine Chemakin*1, Julia Grande1, Jake Gilman1, Maureen McEvoy1, Katie Weichman2
1Reconstructive & Plastic Surgery , Montefiore/Albert Einstein College of Medicine, Bronx, NY; 2Reconstructive & Plastic Surgery, NYU Langone Health, New York, NY
Oncologic breast cancer outcomes are uniquely divided based on menopausal status. This study examines how menopausal status and underlying interactions with menopausal status affect patient quality of life in those undergoing immediate breast reconstruction, measured by the BREAST Q. Treatment strategies differ between pre and post-menopausal patients, and while demographic factors can influence outcomes, menopausal status has not yet been explored.
A retrospective review of patients who underwent mastectomy and immediate breast reconstruction between 2015 to 2021 was conducted. Patients with pre and post-op BREAST-Q surveys were divided into two groups: pre-menopausal and post-menopausal at time of reconstruction. Patients demographics, cancer course, surgical characteristics, and BREAST-Q scores were analyzed. Bivariate statistical analysis was initially done and mean change in BREAST-Q scores were compared. Poisson regression models were used to analyze for potential interactions interacting with menopausal status followed by further stratification.
Out of 125 patients meeting inclusion criteria (55 pre and 70 post), as exprected post-menopausal patients were older with more medical co-morbidities, but no differences in other demographics. Post-menopausal patients reported improvement in satisfaction with breasts and psychosocial satisfaction, while pre-menopausal patients had decreased satisfaction in all categories (breast, psychosocial, chest, abdomen, and sexual). Adjusted models showed significant interactions between menopause and chemotherapy timing, radiation, mastectomy type, and laterality for different satisfaction categories. Further stratification revealed specific parameters affecting BREAST-Q scores differently between menopausal groups.
Underlying interactions between the two groups are potential factors that influence pre and post-menopausal patient’s Breast-Q satisfaction scores differently. These are important factors to note in consultation with patients based off their menopausal status and not age.
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