Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Jun;26(6):1704-1711.
doi: 10.1245/s10434-019-07265-3. Epub 2019 Mar 4.

Breast-Contour-Preserving Procedure as a Multidisciplinary Parameter of Esthetic Outcome in Breast Cancer Treatment in The Netherlands

Annnelotte van Bommel  1   2 , Pauline Spronk  3   4 , Marc Mureau  5 , Sabine Siesling  6   7 , Carolien Smorenburg  8 , Rob Tollenaar  3   4 , Marie-Jeanne Vrancken Peeters  9 , Thijs van Dalen  10
Affiliations

Breast-Contour-Preserving Procedure as a Multidisciplinary Parameter of Esthetic Outcome in Breast Cancer Treatment in The Netherlands

Annnelotte van Bommel et al. Ann Surg Oncol. 2019 Jun.

Abstract

Background: The rate of breast-conserving surgery (BCS) is used as an esthetic outcome parameter, while other treatments contribute also, such as neoadjuvant chemotherapy (NAC) enabling BCS or immediate breast reconstruction (IBR). This study explores these efforts to preserve the patient's breast contour.

Patients and methods: All patients who underwent surgery for invasive breast cancer in The Netherlands between January 2011 and December 2015 were selected from the Dutch national breast cancer audit (n = 61,309). The breast-contour-preserving procedures (BCPP) rate was defined as the rate of primary BCS, BCS after NAC, or mastectomy with IBR. BCPP rates were calculated and compared by year of diagnosis, age categories, and individual hospitals.

Results: The rate of primary BCS remained stable (53%) while the BCPP rate increased from 63% in 2011 to 71% in 2015 due to an increase in patients receiving BCS after NAC and mastectomy with IBR. Primary BCS rates increased with age (from 17% in patients aged < 30 years to 63% in patients aged 60-69 years), while the proportion of patients undergoing mastectomy with IBR decreased from 44% in patients < 30 years to 1% in patients ≥ 70 years. The BCPP rate was similar for all age groups except for patients > 70 years. BCPP rates varied between the different hospitals in The Netherlands, ranging from 47 to 88%.

Conclusions: The chance of preserving the breast contour for patients with breast cancer has increased substantially over recent years. BCPP provides a comprehensive parameter of esthetic outcome of breast cancer surgery.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The authors declare that they have no conflicts of interest. None of the authors has a financial interest in any of the products, devices, or drugs mentioned in this manuscript.

Ethical Approval

For this type of study formal consent is not required.

Figures

Fig. 1
Fig. 1
Annual proportion of patients who underwent a breast-contour-preserving procedure (BCPP) separated by multiple treatment modalities (2011–2015)
Fig. 2
Fig. 2
Multiple treatment modalities of the breast-contour-preserving procedure (BCPP) parameter for patients diagnosed with breast cancer separated by age
Fig. 3
Fig. 3
Correlation per hospital between the proportion of patients who underwent primary breast-conserving surgery (BCS) and the cumulative proportion of patients who had BCS following neoadjuvant chemotherapy and patients who underwent immediate breast reconstruction following mastectomy
See this image and copyright information in PMC

Comment in

References

    1. Netherlands Comprehensive Cancer Organisation. http://www.cijfersoverkanker.nl. [Accessibility verified September 14, 2017].
    1. Aalders KC, van Bommel AC, van Dalen T, et al. Contemporary risks of local and regional recurrence and contralateral breast cancer in patients treated for primary breast cancer. Eur J Cancer (Oxford, England). 2016;63:118–126. doi: 10.1016/j.ejca.2016.05.010. - DOI - PubMed
    1. NABON Breast Cancer Audit. nbca.clinicalaudit.nl. [Accessibility verified September 14, 2017].
    1. van Bommel AC, Spronk PE, Vrancken Peeters MT, et al. Clinical auditing as an instrument for quality improvement in breast cancer care in the Netherlands: The national NABON Breast Cancer Audit. J Surg Oncol. 2017;115(3):243–249. doi: 10.1002/jso.24516. - DOI - PubMed
    1. Killelea BK, Yang VQ, Mougalian S, et al. Neoadjuvant chemotherapy for breast cancer increases the rate of breast conservation: results from the National Cancer Database. J Am Coll Surg. 2015;220(6):1063–1069. doi: 10.1016/j.jamcollsurg.2015.02.011. - DOI - PubMed

MeSH terms