December 9, 2010

Improvement Needed In Mastectomy Outcome Reporting

(Ivanhoe Newswire) -- Every year in the United States about 40% of women with breast cancer undergo a mastectomy.  They say the most important factor in their decision-making is information from health professionals. That information is dependent on the quality, reporting, and interpretation of research data on surgical procedures. Improved standards for outcome reporting in breast reconstruction are needed, according to this study.

To summarize the reporting standards of surgical outcomes in breast reconstruction, Shelley Potter, M.D., of the University of Bristol, and colleagues, reviewed 134 studies reporting surgical outcomes of breast reconstruction involving over 42,000 women. Over half of the studies, or 55%, were cohort studies, 36.6% were case series studies, and 8.2% were randomized controlled trials. Specifically, the researchers looked at prospective or retrospective accrual of data, duration of follow-up, proportion of complications, reporting of total and procedure-specific complications, severity of complications, length of hospital stay, and adjustment for risk factors such as smoking or radiotherapy.

The researchers found insufficient reporting and inconsistency in the data regarding outcomes of breast reconstruction. The studies defined clearly fewer than 20% of the complications they reported, and only half the studies considered risk factors for adverse outcomes. The authors write, "Details such as the severity of complications (41.8% of all studies), duration of follow-up (58.2%) and overall complication rates (59.7%) were often omitted," study authors were quotes as saying. Furthermore, many studies had important methodological problems.

The authors write that their review has indicated the need for a standardized approach to outcome assessment in breast reconstruction that also includes non-clinical factors. "Traditional clinical outcomes remain important, but patient-reported outcomes such as satisfaction, body image, functional results, and cosmetic outcome will also need to be incorporated if the outcomes selected are to be of value to the women making decisions about reconstruction," the authors write.

SOURCE:  Journal of the National Cancer Institute, published online December 3, 2010