PURPOSE: We conducted a propensity matched analysis comparing BREAST-Q scores of patients with lymphedema to those of patients who did not to clarify the impact of a lymphedema diagnosis on patient satisfaction and quality of life follow mastectomy and breast reconstruction.
METHODS: Propensity score matching analysis (1:1 matching, no replacement) was performed comparing patients who received autologous or implant reconstruction with diagnosed lymphedema (ICD-9 or 10 codes) to those without lymphedema. Matched covariates included age, BMI, race, smoking, any radiation, any chemotherapy, postoperative infection, and reconstruction modality/laterality. Outcomes of interest included BREAST-Q scores for satisfaction with breast, physical well-being (WB) of the chest, sexual-WB, and psychosocial-WB domains. The minimum clinically important difference (MCID) for BREAST-Q scores is 4. A p-value of 0.05 was significant.
RESULTS: The overall cohort included 3,268 patients; each matched cohort comprised 322 patients. Matched cohorts did not differ significantly on any covariate. Preoperative BREAST-Q scores did not differ significantly between cohorts. Postoperative BREAST-Q scores significantly differed on all domains, but at different time points. The difference in average score was greater than the MCID for all significantly different domains.
CONCLUSION: Lymphedema has a clinically significant impact on physical-WB of the chest, breast satisfaction, sexual-WB and psychosocial-WB of patients who have undergone breast cancer treatment. Clinicians can use this data to specifically address each domain at appropriate times when counseling patients