American Association of Plastic Surgeons
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Lymphedema And Patient Reported Outcomes: A Propensity Score Matched Analysis
Leslie Kim, MD, Michelle Coriddi, MD, Leslie McGrath, NP, Meghana Shamsunder, MPH, Kathryn Haglich, MS, Jacqueline Chu, BA, Babak Mehrara, MD, Joseph H. Dayan, MD, Jonas A. Nelson, MD, MPH.
Memorial Sloan Kettering Cancer Center, New York, NY, USA.

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 (Table 1). 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


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