부산대학교 도서관

Objective: One of the leading causes of death among women is breast cancer. The disease process and treatment journey consume patients' emotional and physical energy, severely affecting mood, self-esteem, body image, sexual functions, commitment, and overall quality of life. Postmastectomy breast reconstruction is known to revert some of these adversarial conditions. This study uses patient-reported outcome measures (PROMs) to investigate the factors influencing the end result and quality of life regarding postmastectomy breast reconstruction. Material and Method: Thirty-four patients who'd undergone breast reconstruction filled out a questionnaire form including 54 questions pertaining the patients' surgical and oncological history, demographics, mood, self-esteem, body and breast self-image, social and familial support mechanisms, and satisfaction with life and reconstruction. The study then collected anthropometric measurements and standardized photographs and had plastic surgery residents assess aesthetic outcome with regard to the photographs. Result: Half of the patients had immediate while the other half had delayed reconstruction. Of the patients, 10 (29.4%) had reconstructions that only involved an implant, 15 (44.1%) had reconstructions that only involved autogenous tissue, and nine (26.5%) that had both. No significant association could be found for the reconstruction method or timing of the reconstruction with aesthetic results, symmetry, or patient satisfaction. Meanwhile, nipple-areolar complex (NAC) reconstruction contributed to significantly better aesthetic outcomes (p=0.026) and overall patient satisfaction (p=0.029). Scar issues were found to significantly affect satisfaction scores (p=0.008) while not affecting the aesthetic outcome. Conclusion: Neither symmetry nor aesthetic outcome were found to be major factors influencing patients' overall satisfaction with breast reconstruction. However, scars are relevant as constant reminders of past surgeries. Another significant factor in patient satisfaction was NAC reconstruction. Keywords: Breast, reconstruction, cancer, mastectomy, scars, nipple Amac: Meme kanseri kadinlar arasinda onde gelen olum nedenlerinden biridir. Hastaligin seyri ve tedavisi hastalarin duygusal ve fiziksel enerjisini tuketir ve duygu-durumlari, ozguvenlerini, cinsel islevlerini, yasama baglilik ve yasam kalitelerini etkiler. Mastektomi sonrasi meme rekonstruksiyonu bu sorunlarin bir kisminin giderilmesinde yardimci olabilir. Bu hasta tarafindan raporlanan cikti olcutleri calismasinda sonuclari ve hastalarin yasam kalitelerini etkileyen etmenler arastirilmistir. Gerec ve Yontem: Meme rekonstruksiyonu gecirmis toplam 34 hasta cerrahi ve onkolojik oykuleri, demografik verileri, duygu-durumlari, beden ve meme oz algilari, sosyal ve ailesel destek mekanizmalari ile yasam ve rekonstruksiyondan memnuniyetlerini sorgulayan 54 soruluk bir anket yanitladi. Sonrasinda antropometrik olcumler ve standardize fotograflar alindi. Estetik sonuclari bu fotograflarin uzerinden degerlendirildi. Bulgular: Hastalarin yarisina es zamanli, yarisina gec donemde rekonstruksiyon yapilmisti. On hastaya (%29,4) sadece implant ile, 15'ine (%44,1) sadece otojen doku ile ve dokuzuna (%26,5) ikisi de yapilmisti. Rekonstruksiyon metodu veya zamanlamasinin estetik sonuclar, simetri veya hasta memnuniyetiyle aralarinda anlamli bir iliski bulunamadi. Bununla beraber meme basi-areola kompleksi (MAK) rekonstruksiyonu yapilmis olmasi hem estetik sonuclari (p=0,026), hem de hasta memnuniyetini (p=0,029) anlamli derecede olumlu yonde etkilemisti. Ancak nedbe sorunlari estetik sonuclari anlamli derecede etkilemezken hasta memnuniyetini olumsuz yonde etkileyen tek etmen olarak ortaya cikmistir (p=0,008). Sonuc: Meme rekonstruksiyonunda memnuniyeti anlamli olcude etkileyen etmenler arasinda simetri ve estetik sonuc bulunmazken sureci kendilerine animsatan nedbe sorunlari bulunmustur. Hasta memnuniyetini anlamli derecede etkileyen bir diger etmen ise MAK onarimi yapilmis olmasidir. Anahtar Kelimeler: Meme, rekonstruksiyon, kanser, mastektomi, nedbe, meme basi
INTRODUCTION Regarding cancer-related mortality, breast cancer stands as the most prevalent malignancy among women, second only to lung cancer (1). While the incidence of breast cancer is on the rise, [...]