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Factors Associated with Satisfaction with Breasts Following Oncoplastic Mammoplasty
Benjamin D. Wagner
*1, Ron Shemtov
1, Lillian A. Boe
2, Giacomo Montagna
3, Audree B. Tadros
3, J I. Choi
4, Babak J. Mehrara
1, Jonas Nelson
1, Carrie S. Stern
11Plastic and Reconstructive Surgery Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; 2Biostatistics Service, Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY; 3Breast Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY; 4Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY
Background: Oncoplastic breast surgery (OBS) expands breast-conserving options for patients requiring large-volume resections, those with macromastia, or patients with breast ptosis who may benefit from mastopexy at the time of cancer resection. However, patient satisfaction remains variable, and factors influencing long-term Satisfaction with Breasts are not well defined. This study aimed to identify independent predictors of 1-year satisfaction to inform surgical planning and optimize patient-reported outcomes.
Methods: We performed a retrospective analysis of patients who underwent oncoplastic reduction mammoplasty or mastopexy at Memorial Sloan Kettering Cancer Center (2016-2024) and completed the BREAST-Q Satisfaction with Breasts module at 1 year. Demographic, clinical, and treatment variables were evaluated. Multivariable linear regression identified factors independently associated with satisfaction. Missing preoperative BREAST-Q scores were addressed using multiple imputation.
Results: A total of 268 patients were included. Median (IQR) age was 53 (48-61) years and BMI was 27.7 (24.6-32.6) kg/m
2. Overall, 39.2% received chemotherapy and 87.7% received radiation. Wound complications were most common (14.6%), followed by infection (9.3%), seroma (4.1%), hematoma (3.0%), and nipple necrosis (1.9%); 3.0% required reoperation within 90 days. Among patients with complete BREAST-Q data (n = 192), median satisfaction improved from 44 (34-58) preoperatively to 67 (55-88) at 1 year (
P < 0.001), exceeding the MCID. On multivariable analysis, postoperative seroma was independently associated with decreased satisfaction (β = −20; 95% CI, −33 to −6.3;
P = 0.004). Higher BMI, older age, psychiatric diagnoses, and chemotherapy or radiotherapy showed nonsignificant trends toward lower satisfaction.
Conclusion: OBS is associated with significant improvements in Satisfaction with Breasts at 1 year. Postoperative seroma independently predicts worse outcomes, underscoring the importance of complication prevention and targeted perioperative counseling.
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