Abstract
Background
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.
Methods
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.
Results
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.
Conclusions
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.
Keywords
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Article info
Publication history
Published online: December 18, 2016
Accepted:
November 21,
2016
Identification
Copyright
© 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
