Título:	Análise comparativa entre os resultados estéticos de cirurgia oncoplástica e reconstrução mamária total de acordo com o grau de satisfação das mulheres e dos médicos: estudo realizado em serviços brasileiros de mastologia
Autor(es):	Lisboa, Fabiana Christina Araújo Pereira
Orientador(es):	Sousa, João Batista de
Coorientador(es):	Paulinelli, Régis Resende
Assunto:	Mamas - câncer Mastectomia Satisfação do paciente
Data de publicação:	10-Jul-2024
Data de defesa:	8-Dez-2023
Referência:	LISBOA, Fabiana Christina Araújo Pereira. Análise comparativa entre os resultados estéticos de cirurgia oncoplástica e reconstrução mamária total de acordo com o grau de satisfação das mulheres e dos médicos: estudo realizado em serviços brasileiros de mastologia. 2023. 131 f., il. Tese (Doutorado em Ciências Médicas) — Universidade de Brasília, Brasília, 2023.
Abstract:	Introduction: Women’s satisfaction after breast neoplasms surgery has an impact on body image, sexual function, self-esteem, and quality of life and may differ from the perception of the attending physician. This study aimed to compare the aesthetic outcomes and satisfaction of surgeons and women with breast tumors regarding conservative oncoplastic surgeries and total breast reconstruction. Methods: Were included 760 women diagnosed with invasive breast carcinoma or phyllodes tumors who returned at least 6 months after surgery or radiotherapy at two public hospitals (Clinics Hospital of the Federal University of Goias and Araujo Jorge Cancer Hospital) and a private clinic between 2014 and 2022. Data was collected prospectively from patients and retrospectively from their medical records using a specific form after obtaining their informed consent. Aesthetic outcomes and quality of life were assessed using the BREAST-Q©, Harris Scale, and BCCT.core software. Data were evaluated using the SPSS statistical software. Statistical significance was set at p < 0.05. This study was approved by the hospital ethics committees. Results: A total of 405 (53.29%) partial and 355 (46.71%) total reconstructions were included. Women who underwent partial reconstruction were older 56 years (+/- 11.59) (p< 0,001) and had higher body mass index 26.67 (24.34 – 29.34) (p< 0,001). Women who underwent total reconstruction had larger tumors 40 mm (25 – 55.50) (p< 0,001) with advanced clinical (p< 0,001) and pathological stages (II e III) (p 0,037). Clinical and surgical complications occurred more frequently in the total reconstruction group (p< 0,001). A greater number of reparative surgeries and lipofilling procedures were required for total reconstruction (p< 0,001). According to the BREAST-Q, the partial reconstruction group showed significantly higher levels of women's satisfaction with their breasts (p< X 0,001), the surgical outcomes (p< 0,001), psychosocial (p 0,049) and sexual well-being (p 0,002), provision of information (p 0,001), and the reconstructive surgeon (p 0,004). Only physical well-being was slightly higher in the total reconstruction group (p 0,009). Surgeons considered partial reconstructions to have better results than total reconstructions, in most cases, the results were rated good or excellent. Although this difference was not perceived by the BCCT.core software. Conclusion: Women who underwent partial breast reconstruction had higher levels of satisfaction in several domains, lower frequency of complications, and required fewer surgeries to complete their reconstruction than women who underwent total reconstruction. Surgeons were also more satisfied with the results of partial reconstructions.
Unidade Acadêmica:	Faculdade de Medicina (FM)
Informações adicionais:	Tese (doutorado)—Universidade de Brasília, Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, 2023.
Programa de pós-graduação:	Programa de Pós-Graduação em Ciências Médicas
Licença:	A concessão da licença deste item refere-se ao termo de autorização impresso assinado pelo autor com as seguintes condições: Na qualidade de titular dos direitos de autor da publicação, autorizo a Universidade de Brasília e o IBICT a disponibilizar por meio dos sites www.bce.unb.br, www.ibict.br, http://hercules.vtls.com/cgi-bin/ndltd/chameleon?lng=pt&skin=ndltd sem ressarcimento dos direitos autorais, de acordo com a Lei nº 9610/98, o texto integral da obra disponibilizada, conforme permissões assinaladas, para fins de leitura, impressão e/ou download, a título de divulgação da produção científica brasileira, a partir desta data.
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