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. 2017 Jul 24;5(7):e1419.
doi: 10.1097/GOX.0000000000001419. eCollection 2017 Jul.

Patient-Reported Outcomes Are Better after Oncoplastic Breast Conservation than after Mastectomy and Autologous Reconstruction

Natalie D Chand  1 , Victoria Browne  1 , Nirmala Paramanathan  1 , Lashan J Peiris  1 , Siobhan A Laws  1 , Richard M Rainsbury  1
Affiliations

Patient-Reported Outcomes Are Better after Oncoplastic Breast Conservation than after Mastectomy and Autologous Reconstruction

Natalie D Chand et al. Plast Reconstr Surg Glob Open. .

Abstract

Oncoplastic breast-conserving surgery (OBCS) avoids mastectomy for larger tumors, but patient-reported outcomes are unknown.

Methods: The BREAST-Q questionnaire was distributed to 333 women following therapeutic mammaplasty or latissimus dorsi (LD) miniflap since 1991 [tumor diameter, 32.5 (5-100) mm). QScore software generated scores/100 for breast appearance, physical, emotional, and sexual wellbeing. Outcomes following therapeutic mammaplasty and LD miniflap were compared and qualitative data analyzed to identify common themes relating to satisfaction.

Results: One hundred fifty (45%) women responded [mammaplasty versus LD miniflap, 52% versus 42%; age, 52 (30-83) years; follow-up, 84 (4-281) months). Eighty-nine percent rated OBCS better than mastectomy, > 80% recommending it to others. Mean outcome scores for breast appearance, physical, and emotional wellbeing were high and persisted beyond 15 years. Therapeutic mammaplasty patients were significantly more satisfied than those undergoing LD miniflap with the shape (P < 0.05), the size (P < 0.005), and the natural feel of the treated breast (P = 0.01). They demonstrated similar scores for physical and emotional wellbeing and a lower score for sexual wellbeing than LD miniflap patients. More LD miniflap patients reported back/shoulder symptoms and were more likely to report upper back pain (P < 0.05), but very few (< 5%) were concerned about donor-site appearance. Overall satisfaction with surgical outcomes was high in both OBCS groups (82% "excellent/very good") but greatest after therapeutic mammaplasty (P < 0.005).

Conclusions: Patients report long-lasting satisfaction after OBCS and outcomes that compare very favorably with those reported following mastectomy and immediate autologous reconstruction.

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Conflict of interest statement

Disclosure: The authors have no financial interest to declare in relation to the content of this article. The Article Processing Charge was paid for by the Wessex Cancer Research Fund.

Figures

Fig. 1.
Fig. 1.
A, Satisfaction with the postoperative appearance of the breast following OBCS and immediate autologous reconstruction. B, Physical wellbeing following OBCS and immediate autologous reconstruction. C, Emotional wellbeing following OBCS and immediate autologous reconstruction. D, Sexual wellbeing following OBCS and immediate autologous reconstruction.
Fig. 2.
Fig. 2.
Mean outcome scores following mastectomy alone, immediate reconstruction, and OBCS.
See this image and copyright information in PMC

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