Back to 2014 Annual Meeting Abstracts

BACKGROUND:
Breast conservation therapy has become increasingly employed to treat breast cancer patients, and techniques reconstructing partial mastectomy defects have become more extensive and aesthetically tailored. While breast conservation therapy may offer several benefits such as increased patient self-esteem and quality-of-life, poor cosmetic outcomes occur in approximately 30% of patients; rates of approximately 7% can be obtained after 2 years. Symmetry appears to be the most important determinant of cosmetic outcome. In this study, we aimed to study the post-operative outcome and patient satisfaction of patients who had undergone partial mastectomy with oncoplastic reconstruction.
METHODS:
After obtaining Institutional Review Board approval, we conducted a retrospective chart review of all patients who underwent oncoplastic breast reconstruction by a single plastic surgeon between July 2011 and December 2013. Patient charts were reviewed for demographic information, comorbidies, breast size, need for radiation or chemotherapy, intra-operative technique, and post-operative complications. The patients in the cohort were then sent an adapted questionnaire based on the post-operative BREAST-Q.
RESULTS:
All of the 85 patients were female, with an average age of 45.94 years and an average BMI of 25.65. All patients underwent tumor excision and immediate oncoplastic breast reconstruction. Fifty-three women underwent a symmetry procedure on the unaffected side, 25 of which were performed in a delayed setting. No symmetry procedures occurred before a patient underwent radiation therapy following oncoplastic surgery. The average time from initial operation to final operation was 4.5 months, ranging from 1 month to 16 months. Contracture was noted in 2 patients who underwent radiation therapy following their oncoplastic surgery; these patients will likely require symmetry procedures in the future. Four patients noted skin changes including hyper-pigmentation and a mild burn following radiation therapy. Complications occurred in 4 patients, and included breast implant infection (n=1), wound dehiscence (n=1), infected hematoma (n=1), and an uninfected hematoma (n=1). Our survey response rate was 37.6%. Three-fourths of the patients reported being somewhat or very satisfied with regard to different aspects of their breast symmetry. Almost seventy-eight percent of patients stated that they would undergo the procedure again, and 81% reported having no regrets about having the surgery.
CONCLUSIONS:
Our results indicate that a high level of patient satisfaction regarding oncoplastic surgery is obtainable, and a large majority of women have no regrets about undergoing surgery and would do it again. Consistent with previous studies, symmetry between breasts following oncoplastic surgery influences patient satisfaction.