乳房再建領域における患者立脚型評価

Evaluating Breast Reconstruction from the Patientʼs Perspective

はじめに

　乳癌は比較的予後良好な悪性腫瘍であり，サバイバーのQOLを保つことは治療選択において重要な要素である。乳癌手術による乳房の喪失・変形は，整容性のみならず心理的，社会的にも女性のQOLを損なう可能性があり，乳房再建はこれらの苦痛を軽減する支持療法の1つである。一方で，わが国では術後のQOL評価が十分になされておらず，QOLを計量し臨床にフィードバックすることは今後の課題である。

　Breast cancer surgery has advanced in terms of oncoplastic surgery, and breast reconstruction (BR) is one of the supportive treatments that contributes to a reduction of the psychosocial distress that may be experienced by patients with breast cancer. There are many challenges in the clinical practice of BR, however. In addition to establishing a surgical technique for BR that provides a higher degree of aesthetic satisfaction and better quality of life, the quality of the patientsʼ medical care must be improved. There is a growing movement to utilize patient-reported outcome measures (PROMs) as part of the assessment of surgical outcomes, including the outcomes of BRs. Japanese versions of two surgery-specific quality of life and patient satisfaction PROMs have been developed: the BREAST-Q and the EORTC QLQ-BRECON23 questionnaires. The use of these metrics are expected to (i) contribute to the accumulation of data that are unique to Japan and (ii) evaluate breast reconstructions from the patientsʼ perspectives.