Influence of age on patient decision regret following breast reconstruction: A multicenter collaborative study in Japan

BACKGROUND In recent years, the age range of patients undergoing breast reconstruction has expanded. Establishment of the influence of the age of a patient with breast cancer on the level of regret after breast reconstruction could assist in decision-making across age groups at the time of choice of options for breast cancer surgery. OBJECTIVES The objective of the study is to investigate the current age distribution of patients undergoing treatment for breast cancer in Japan through a multicenter collaborative study, and to examine the impact of age on post-surgical decision regret, analyzed by type of surgical procedure. METHODS A multicenter observational retrospective study was conducted in 576 patients who were diagnosed with breast cancer pathologically and underwent mastectomy (Bt), breast-conserving surgery (Bc) or breast reconstruction (Br). Demographic and outcome data were collected and the level of regret concerning the surgical decision was surveyed using the Decision Regret Scale (DRS) across the different patient groups. RESULTS The average age of the Bt group was significantly higher than those in the Bc and Br groups. The level of regret was slightly but significantly higher in the Br group compared to the other groups. Regression analysis of the relationship between age and DRS scores indicated that reconstruction is associated with an increase of about 5 points in the DRS score. This analysis also revealed that the DRS score slightly increases with advancing age, regardless of the surgical method. CONCLUSIONS In reconstruction cases, addition of new surgical procedures may lead to more complications, which might have slightly increased regret; however, the increase was not significant. Although minor, it is also important to note the tendency for the level of regret to increase with age.