Qualidade de vida, satisfação com a cirurgia e morbidade no ombro e braço de mulheres com câncer de mama submetidas à quadrantectomia ou à mastectomia com reconstrução imediata

Abstract

OBJECTIVES: To compare the prevalence of shoulder-arm morbidity, quality of life (QOL) and satisfaction with surgical treatment in women submitted to quadrantectomy with those submitted to modified radical mastectomy (MRM) with immediate breast reconstruction (IBR). METHODS: A cross-sectional study was performed on women with breast cancer who had been submitted to quadrantectomy or to MRM+IBR with a transverse rectus abdominis myocutaneous (TRAM) flap, who had completed treatment at least six months previously. A total of 44 women submitted to quadrantectomy and 26 submitted to MRM+IBR were included in the study. RESULTS: Prevalence of lymphedema was 12% in the MRM+IBR group and 18% in the quadrantectomy group (OR: 0.51; 95%CI: 0.02-10.1; p=0.66). There was a greater prevalence of restricted inner shoulder rotation in the women submitted to quadrantectomy (OR: 7.23; 95%CI: 1.28-17.1; p=0.03). There was no difference in QOL scores or satisfaction with surgery. When the participants were questioned whether they would have opted for a different surgical technique, 25% of women in the MRM+IBR group and 12% in the quadrantectomy group reported that they would have made a different choice (adjusted analysis, OR: 7.4; 95%CI: 0.7- 73.3; p=0.09). CONCLUSIONS: The present findings suggest that the type of surgery does not affect the occurrence of lymphedema. Quadrantectomy increased the likelihood of restricted shoulder movement. In addition, the two surgical techniques evaluated were found to exert a similar effect on QOL and on the woman s satisfaction with surgery.