Cosmetic satisfaction and decision regret in older Chinese breast cancer patients following breast conservation or mastectomy

Abstract

<p>Few studies have looked into the best surgical treatment for older breast cancer patients, with many opting for a mastectomy for simplicity. The purpose of this study was to compare the cosmetic satisfaction and decision regret of older Chinese patients who had breast-conserving surgery (BCS) versus mastectomy. Female Chinese patients aged 70 or older when diagnosed with breast cancer were recruited between September 2019 and December 2021. The Chinese version of the BREAST-Q survey was used to assess satisfaction with breast cosmesis before and after surgery. The Decision Regret Scale was used to characterize decision regret six months after the operation. A comprehensive geriatric assessment was performed, as well as quality of life (QoL) measures. Eighty-six patients fulfilled the recruitment criteria, and 77 of them consented to the study and completed the questionnaires (90% participation rate). Fifty-three patients (68.8%) underwent a mastectomy, while twenty-four patients (31.2%) underwent BCS. At six months after the operation, patients who had a mastectomy were found to be less satisfied with the cosmetic outcome of their breasts (<em>p</em> = 0.012). Breast cosmesis satisfaction remained similar in the group of patients who received a BCS (<em>p</em> = 0.550). Neither group expressed regret in their choice of operation option (<em>p</em> = 0.429). Patients who received BCS had better social support (<em>p</em> = 0.025). There was no significant difference in QoL measures. The cosmetic outcome of a mastectomy can cause significant dissatisfaction in older adults. It is critical to engage patients in discussions about surgical options so that they can make an informed decision.</p><p><strong>Keywords: </strong>Breast cancer; cosmetic outcome; decision regret.</p>