4.4 Article

An analysis of complication rates and the influence on patient satisfaction and cosmetic outcomes following oncoplastic breast surgery

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ELSEVIER SCI LTD
DOI: 10.1016/j.bjps.2022.06.088

Keywords

Breast reconstruction; Oncoplastic breast surgery; Volume replacement; Volume displacement; Complications; Quality of life; Cosmetic outcomes; BREAST-Q; Medical photographs

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This study evaluated complication rates, patient satisfaction, and cosmetic outcomes after oncoplastic breast-conserving surgery (OPS). The overall complication rate was 18.7%, and patients were generally satisfied with the procedure, with most cosmetic outcomes rated as good to excellent. There were no significant differences in complications between volume replacement and volume displacement techniques, but patients who underwent volume displacement reported lower cosmetic outcome scores for mammary symmetry. The occurrence of complications resulted in lower patient satisfaction and cosmetic outcomes.
Introduction: This study aimed to evaluate complication rates, patient satisfac-tion, and cosmetic outcomes after oncoplastic breast-conserving surgery (OPS). Furthermore, outcome differences between volume displacement and volume replacement techniques and the effect of postoperative complications on outcomes were evaluated.Methods: This was a prospective single-center study addressing patients who underwent OPS from 2017 to 2020. The BREAST-Q was used to measure patient satisfaction, and cosmetic out-comes were assessed by patient self-evaluation and panel evaluation based on medical pho-tographs.Results: A total of 75 patients were included. The overall complication rate was 18.7%, of which 4% required invasive interventions. Median BREAST-Q scores ranged from 56 to 100 and cosmetic outcomes were scored good to excellent in 60-86%. No differences in complications were observed between volume replacement and volume displacement techniques. Follow-ing volume displacement techniques, patients-reported higher BREAST-Q scores for the domain physical well-being of the chest and lower cosmetic outcomes scores for mammary symme- try. Patients with complications scored significantly lower on several domains of the BREAST-Q and in various cosmetic outcome categories. Conclusion: In this cohort, an overall complication rate of 18.7% was observed. Patients were generally satisfied, and most cosmetic outcomes were good to excellent. Volume displacement or replacement techniques were performed for different indications and generally showed com-parable results. Expected differences in physical discomfort and symmetry between both tech-niques were observed. In addition, the occurrence of complications resulted in lower patient satisfaction and cosmetic outcomes. These findings emphasize the importance of thorough pre-operative counselling. (c) 2022 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Pub-lished by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)

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