Recent studies implicate that oncoplastic breast cancer surgery provides better aesthetic outcome than conventional resection. Several factors have been associated with poor aesthetic outcome. This study aims to compare patient-reported aesthetic and functional outcome after conventional and oncoplastic resection and to evaluate prognostic factors for poor aesthetic outcome in a population-based setting.
637 patients having breast conserving treatment (BCT) due to unilateral primary breast cancer at a single hospital district during 2010 were included. Aesthetic and functional outcome were evaluated using two questionnaires three years after surgery.
Questionnaires were returned by 379 (59%) patients; 293 (77%) of these had conventional and 86 (23%) oncoplastic resection. Patients in oncoplastic resection group had larger tumour diameter (p < 0.001), larger resection specimens (p < 0.001), and more often multifocal tumours (p = 0.032), node positive cancer (p = 0.029) and lower quadrant tumour localization (p = 0.007). Aesthetic outcome according to BCTOS questionnaire was good in 284 (75%) patients; 52 (61%) patients in the oncoplastic group and 230 patients (81%) in the conventional resection group, p < 0.001. Larger tumour diameter (p = 0.033), multifocality (p = 0.022), weight of resection specimen (<0.001) and oncoplastic surgery (p < 0.001) were predicting poor aesthetic outcome, when all patients were included. Tumour multifocality (p = 0.013) remained predictor of poor aesthetic outcome in conventional resection group but not in oncoplastic resection group.
Patient satisfaction to aesthetic outcome after BCT is high. Conventional resection provides good aesthetic outcome in appropriately selected patients. Oncoplastic resection enables BCT in patients with larger and multifocal tumours with favourable aesthetic outcome.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to European Journal of Surgical Oncology
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Change of aesthetic and functional outcome over time and their relationship to quality of life after breast conserving therapy.Eur J Surg Oncol (EJSO). 2011; 37: 116-121
- Aesthetic and functional results after breast conserving surgery as correlates of quality of life measured by a German version of the breast cancer treatment outcome scale (BCTOS).Breast. 2010; 19: 470-474
- Long-term comparison of aesthetical outcomes after oncoplastic surgery and lumpectomy in breast cancer patients.Ann Surg Oncol. 2015; 22: 2500-2508
- Predictors of early poor aesthetic outcome after breast-conserving surgery in patients with breast cancer: initial results of a prospective cohort study at a single institution.J Surg Oncol. 2014; 110: 801-806
- Long-term objective esthetic outcome after breast-conserving therapy.Breast Cancer Res Treat. 2015; 153: 345-351
- Do reexcisions impair aesthetic outcome in breast conservation surgery? Exploratory analysis of a prospective cohort study.Ann Surg Oncol. 2012; 19: 541-547
- Long-term cosmetic changes after breast-conserving treatment of patients with stage I–II breast cancer and included in the EORTC ‘boost versus no boost’ trial.Ann Oncol. 2012; 23: 2591-2598
- The influence of patient, tumor and treatment factors on the cosmetic results after breast-conserving therapy in the EORTC ‘boost vs. no boost’ trial.Radiotherapy Oncol. 2000; 55: 219-232
- How safe is oncoplastic breast conservation?: comparative analysis with standard breast conserving surgery.Eur J Surg Oncol (EJSO). 2012; 38: 395-398
- A meta-analysis comparing breast conservation therapy alone to the oncoplastic technique.Ann Plast Surg. 2014; 72: 145-149
- Breast conservative surgery and local recurrence.Breast. 2015; 24: S100-S107
- Oncological results of oncoplastic breast-conserving surgery: long term follow-up of a large series at a single institution: a matched-cohort analysis.Eur J Surg Oncol. 2016 Jan; 42: 71-77
- A systematic review of oncoplastic breast-conserving surgery: current weaknesses and future prospects.Ann Surg. 2013; 257: 609-620
- The influence of simultaneous integrated boost, hypofractionation and oncoplastic surgery on cosmetic outcome and PROMs after breast conserving therapy.Eur J Surg Oncol. 2015; 41: 1411-1416
- Measuring quality of life in oncologic breast surgery: a systematic review of patient-reported outcome measures.Breast J. 2010; 16: 587-597
- Form or function? Part 1. subjective cosmetic and functional correlates of quality of life in women treated with breast-conserving surgical procedures and radiotherapy.Cancer. 2001; 91: 2273-2281
- Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery.Ann Surg Oncol. 2010; 17: 1375-1391
- The quality of preoperative diagnostics and surgery and their impact on delays in breast cancer treatment – a population based study.Breast. 2016; 26: 80-86
- Systematization of oncoplastic surgery: selection of surgical techniques and patient-reported outcome in a cohort of 1,035 patients.Ann Surg Oncol. 2015; 22: 3730-3737
- Outcome of oncoplastic breast surgery in 90 prospective patients.Am J Surg. 2010; 200: 224-228
Published online: December 18, 2016
Accepted: November 21, 2016
© 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.