ASO Author Reflections: Propensity Score-Matched Patient-Reported Outcomes After Breast-Conserving Therapy and Postmastectomy Breast Reconstruction

In the 1880s, Halsted developed the radical mastectomy for breast cancer treatment, and this remained the gold standard for breast cancer surgery for the next century.¹ Breast-conserving therapy (BCT) was first introduced in the 1980s after early randomized controlled trials demonstrated that survival and local disease control for early breast cancer were comparable with those of mastectomy.² Many women with breast cancer are candidates for BCT or mastectomy and are faced with deciding between these two options. Multiple factors continue to influence the decision-making of patients choosing between surgical interventions.³ The influence of this surgical choice on patient-reported outcomes (PROs), however, has been studied only limitedly. Recent literature demonstrates that patients who undergo BCT have significantly better quality of life than those who undergo postmastectomy breast reconstruction (PMBR), but the data may be confounded by inherent differences in patient characteristics and treatment between these two cohorts of patients.^4,5 …