Does receipt of preference sensitive care impact patient reported outcomes following breast cancer surgery?

Patients with early breast cancer have multiple surgical options, with their choice being based on personal values, and ultimately being preference sensitive. Most patients will choose breast conserving surgery (BCS) as their preferred management, with some ultimately requiring mastectomy. These patients may have lower satisfaction with this approach than others choosing mastectomy as their preferred option.

The BREAST-Q patient reported outcomes (PRO) measurement tool was retrospectively administered to patients undergoing mastectomy.

Patients choosing an index mastectomy had higher satisfaction with breasts score than those originally having BCS (58.0 vs 44.0; p = 0.012). Quality of life domains were also higher in those originally choosing a mastectomy, including: psychosocial (72.5 vs 63.0; p = 0.019), sexual (48.0 vs 36.0; p = 0.042), and physical well being of the chest domains (80.0 vs 72.0; p = 0.031).

Patients undergoing mastectomy after initial breast conserving surgery report lower PRO's than those initially choosing mastectomy. This suggests that patient preferences need to be considered when interpreting PRO's following breast cancer surgery.