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. 2023 Nov;30(12):7091-7098.
doi: 10.1245/s10434-023-13962-x. Epub 2023 Aug 9.

Long-Term Patient-Reported Outcomes Comparing Oncoplastic Breast Surgery and Conventional Breast-Conserving Surgery: A Propensity Score-Matched Analysis

Linda M Pak  1 , Regina Matar-Ujvary  1 , Francys C Verdial  1 , Kathryn A Haglich  2 , Varadan Sevilimedu  3 , Jonas A Nelson  2 , Mary L Gemignani  4
Affiliations

Long-Term Patient-Reported Outcomes Comparing Oncoplastic Breast Surgery and Conventional Breast-Conserving Surgery: A Propensity Score-Matched Analysis

Linda M Pak et al. Ann Surg Oncol. 2023 Nov.

Abstract

Introduction: Oncoplastic breast surgery (OBS) combines plastic surgery techniques with conventional breast-conserving surgery (BCS) and expands BCS eligibility. Limited data are available on patient-reported outcomes (PROs) after OBS. Here we compare long-term PROs after OBS and BCS utilizing the BREAST-Q.

Patients and methods: Women undergoing OBS or BCS between 2006 and 2019 who completed ≥ 1 long-term BREAST-Q survey 3-5 years postoperatively were identified. Baseline characteristics were compared between women who underwent OBS/BCS. Women who underwent OBS were paired with those who underwent BCS using 1:2 propensity matching [by age, body mass index (BMI), race, T stage, and multifocality]. BREAST-Q scores were compared preoperatively and 3-5 years postoperatively.

Results: A total of 297 patients were included for analysis (99 OBS/198 BCS). Women who underwent OBS were younger (p < 0.001) and had higher BMI (p = 0.005) and multifocal disease incidence (p = 0.004). There was no difference between groups in nodal stage, re-excision rates, axillary surgery, chemotherapy, endocrine therapy, or radiotherapy. After propensity matching preoperatively, women who underwent OBS reported lower psychosocial well-being (63 versus 100, p = 0.039) but similar breast satisfaction and sexual well-being compared with women who underwent BCS; however, only three patients who underwent BCS had preoperative BREAST-Q scores available for review. In long-term follow-up, women who underwent OBS reported lower psychosocial scores (74 versus 93, p = 0.011) 4 years postoperatively, but not at 5 years (76 versus 77, p = 0.83). There was no difference in long-term breast satisfaction or sexual well-being.

Conclusions: Women who undergo OBS present with a larger disease burden and may represent a group of non-traditional BCS candidates; they reported similar long-term breast satisfaction and sexual well-being compared with women who undergo BCS. While women who underwent OBS reported lower psychosocial well-being scores preoperatively and during a portion of the follow-up period, this difference was no longer seen at 5 years postoperatively.

Keywords: BREAST-Q; Breast cancer; Breast-conserving surgery; Oncoplastic breast surgery; Patient-reported outcome measures; Propensity matching.

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Figures

Fig. 1.
Fig. 1.
Matched cohort distribution of BREAST-Q scores preoperatively, and in long-term follow-up, for OBS and BCS patients in the domains of A) satisfaction with breasts, B) psychosocial well-being, and C) sexual well-being. BCS breast-conserving surgery OBS oncoplastic breast surgery
See this image and copyright information in PMC

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