Obese Women Experience Fewer Complications after Oncoplastic Breast Repair following Partial Mastectomy Than after Immediate Total Breast Reconstruction

Tong, Weiwei; Baumann, Donald P.; Villa, Mark Timothy; Mittendorf, Elizabeth A.; Li, Jun; Robb, Geoffrey L.; Kronowitz, Steven J.; Garvey, Patrick B.

doi:10.1097/01.prs.0000479939.69211.19

Cited by 53 publications

(20 citation statements)

References 51 publications

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“…Although most women are offered TM to avoid poor cosmetic outcomes associated with standard BCS, over 40 per cent are offered TM to avoid mastectomy. Recent work comparing the outcomes of women undergoing TM and those undergoing mastectomy and immediate breast reconstruction suggests that TM may be associated with fewer complications 44 and better body image, function and quality of life than mastectomy and reconstruction 45 . The majority of women undergoing TM in the present study had a high BMI and co-morbidities that may have made them unsuitable or high risk for immediate breast reconstruction, and the procedure may have particular quality-of-life benefits for this group of patients.…”

Section: Discussionmentioning

confidence: 99%

Current practice and short-term outcomes of therapeutic mammaplasty in the international TeaM multicentre prospective cohort study

O’Connell

Baker

Trickey

et al. 2018

British Journal of Surgery

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Section: Discussionmentioning

confidence: 99%

Current practice and short-term outcomes of therapeutic mammaplasty in the international TeaM multicentre prospective cohort study

O’Connell

Baker

Trickey

et al. 2018

British Journal of Surgery

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“… 41 Additionally, as OBCS is increasingly being utilized as an alternative to mastectomy, with or without, immediate reconstruction, this approach may offer a lower complication rate compared with total mastectomy and reconstruction, particularly if radiotherapy is being given in the adjuvant setting. 3 , 5 , 59 Potential benefits of this approach could be improved patient satisfaction, quality of life, as well as decreased health care costs compared with full breast reconstruction. 67 …”

Section: Introduction – Obcs: Rationale Definitiomentioning

confidence: 99%

Oncological safety and cosmetic outcomes in oncoplastic breast conservation surgery, a review of the best level of evidence literature

Campbell

Romics

2017

BCTT

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Oncoplastic breast conservation surgery (OBCS) is increasingly becoming part of routine breast cancer surgical management. OBCS may be viewed as an extension of standard breast conservation surgery for resecting tumors of larger sizes without compromising on cosmetic outcome, or as an alternative to mastectomy. High quality evidence to support the oncological safety and benefits of OBCS is lacking. This review will focus on the best available level of evidence and address key issues regarding oncological safety in OBCS, such as tumor resection margins and re-excision rates, local recurrence and patient outcome, postoperative complications and adjuvant therapy delivery, and briefly discuss cosmetic outcome in OBCS. Comparative observational studies and systematic review report no poorer outcomes compared with standard breast conservation surgery. More evidence needs to be generated to support the oncological safety and improved aesthetic outcome. Prospective data collection will significantly contribute to the generation of stronger evidence.

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“…Only four (2.7 per cent) studies used the validated Clavien–Dindo classification 39–42 . Certain studies, which did not classify complications formally, did report complications requiring reoperation or readmission separately ( n = 19, 12.8 per cent) 15 , 32 , 43–59 . Most studies ( n = 95, 81.2 per cent) did not clarify the measurement period for postoperative complications.…”

Section: Resultsmentioning

confidence: 99%

“…The majority ( n = 29, 72.5 per cent) did not define ‘delay’, and reported number of days/weeks until radiotherapy, chemotherapy or first adjuvant treatment. A minority of studies ( n = 10, 25.0 per cent) defined delays to adjuvant therapy with varying temporal cut-offs, for example less than or equal to 4 weeks ( n = 2) 15 , 48 , 6 weeks ( n = 4) 8 , 32 , 41 , 67 and 8 weeks ( n = 2) 35 , 68 after operation. Two studies differentiated the cut-off for chemotherapy and radiotherapy as 6 and 8 weeks after surgery, respectively 52 , 69 .…”

Section: Resultsmentioning

confidence: 99%

Outcome reporting in therapeutic mammaplasty: a systematic review

et al. 2021

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Background Therapeutic mammaplasty (TM) is an oncological procedure which combines tumour resection with breast reduction and mastopexy techniques. Previous systematic reviews have demonstrated the oncological safety of TM but reporting of critically important outcomes, such as quality of life, aesthetic and functional outcomes, are limited, piecemeal or inconsistent. This systematic review aimed to identify all outcomes reported in clinical studies of TM to facilitate development of a core outcome set. Methods Medline, EMBASE, CINAHL and Web of Science were searched from inception to 5 August 2020. Included studies reported clinical outcomes following TM for adult women. Two authors screened articles independently for eligibility. Data were extracted regarding the outcome definition and classification type (for example, oncological, quality of life, etc.), time of outcome reporting and measurement tools. Results Of 5709 de-duplicated records, 148 were included in the narrative synthesis. The majority of studies (n = 102, 68.9 per cent) reported measures of survival and/or recurrence; approximately three-quarters (n = 75, 73.5 per cent) had less than 5 years follow-up. Aesthetic outcome was reported in half of studies (n = 75, 50.7 per cent) using mainly subjective, non-validated measurement tools. The time point at which aesthetic assessment was conducted was highly variable, and only defined in 48 (64.0 per cent) studies and none included a preoperative baseline for comparison. Few studies reported quality of life (n = 30, 20.3 per cent), functional outcomes (n = 5, 3.4 per cent) or resource use (n = 28, 18.9 per cent). Conclusion Given the oncological equivalence of TM and mastectomy, treatment decisions are often driven by aesthetic and functional outcomes, which are infrequently and inconsistently reported with non-validated measurement tools.

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Obese Women Experience Fewer Complications after Oncoplastic Breast Repair following Partial Mastectomy Than after Immediate Total Breast Reconstruction

Abstract: Therapeutic, III.

Cited by 53 publications

References 51 publications

Current practice and short-term outcomes of therapeutic mammaplasty in the international TeaM multicentre prospective cohort study

Current practice and short-term outcomes of therapeutic mammaplasty in the international TeaM multicentre prospective cohort study

Oncological safety and cosmetic outcomes in oncoplastic breast conservation surgery, a review of the best level of evidence literature

Outcome reporting in therapeutic mammaplasty: a systematic review

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