Oncoplastic Surgery: Does Patient and Medical Specialty Influences the Evaluation of Cosmetic Results?

Oliveira‐Junior, Idam de; Silva, Fabíola Cristina Brandini da; Nazima, Flávio; Ribeiro, José Carlos; Castellani, Laurinda; Zucca-Matthes, Gustavo; Maciel, Maria do Socorro; Biller, Gabriele; Silva, Jonathas José da; Sarri, Almir José; Vieira, René Aloísio da Costa

doi:10.1016/j.clbc.2020.09.012

Cited by 5 publications

(4 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, because breast cancer survival has been a reality and patients end up experiencing greater treatment morbidity over the years, the aesthetic outcome of the breast has become one of the pillars of cancer treatment, with a priority of patient satisfaction. Thus, the results reported by the patients are a current issue that deserves to be discussed and addressed, as in the present study ( 21 , 22 ).…”

Section: Discussionmentioning

confidence: 69%

“…Our study, which included only patients undergoing BCS, sought to evaluate the factors associated with an unsatisfactory cosmetic outcome in OS, both according to the patient and through a previously consolidated and reproducible objective methodology via BCCT.core. The correlation among cosmetic evaluations of breast surgery is low among different methodologies ( 16 , 21 ), as are the factors that influence unsatisfactory results. In the patient self-assessment, younger women with higher BMI at the time of evaluation, with larger tumors and heavier surgical specimen tended to present with unsatisfactory breast results.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Factors associated with unsatisfactory cosmetic results in oncoplastic surgery

et al. 2023

Self Cite

View full text Add to dashboard Cite

IntroductionOncoplastic surgery (OS) has expanded the indications for breast-conserving surgery associated with an adequate aesthetic result. However, few studies have described the factors associated with unsatisfactory cosmetic outcomes from this surgical modality.Materials and methodsThis is a cross-sectional prospective study that included patients undergoing breast-conserving surgery (BCS) with or without OS. The patients self-evaluated the cosmetic results of the breasts posttreatment and had them photographed. The photos were analyzed by BCCT.core. Individual and treatment factors (local and systemic) for all patients were evaluated. These factors were dichotomized according to the use of OS and to the cosmetic result (satisfactory and unsatisfactory). Categorical variables were tested for association with surgical outcome using the chi-square test while numerical variables using the Mann−Whitney U test. Variables with p <0,2 were selected for multivariate analysis.ResultsOf the 300 patients evaluated, 72 (24,0%) underwent OS. According to the patient self-evaluations, an unsatisfactory cosmetic result from OS was significantly associated with younger age at diagnosis, higher body mass index (BMI) at the time of evaluation, larger tumor size and greater weight of the surgical specimen. According to the BCCT.core, only the laterality of the tumor (left) was significantly associated with an unsatisfactory cosmetic result. In logistic regression, considering OS as a control variable, the risk of an unsatisfactory outcome according to patient self-evaluation was related to the tumor ≥ T2 odds ratio (OR) 1,85 (1,027-3,34) and age at diagnosis < 40 [OR 5,0 (1,84-13,95)]. However, according to the software, the variables were associated with an increased risk of an unsatisfactory outcome were the time interval between surgery and evaluation [OR 1,27 (1,16-1,39)], the presence of lymphedema [OR 2,97 (1,36-6,46)], surgical wound infection [OR 3,6 (1,22-11,16)], tumor location on the left side [OR 3,06 (1,69-5,53)], overweight [OR 2,93 (1,48-5,8)] and obesity [OR 2,52 (1,2-5,31)].ConclusionThere is no standard methodology for breast cosmesis evaluation, which influences the factors associated with unsatisfactory results. Younger patients and those with increased BMI, left breast cancer and extensive resections tend to present with unsatisfactory cosmetic results when OS is performed.

show abstract

Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

Factors associated with unsatisfactory cosmetic results in oncoplastic surgery

et al. 2023

Self Cite

View full text Add to dashboard Cite

show abstract

“…Symmetrisation has an unknown impact on quality of life ( 56 ) since patients evaluate their cosmesis better than health professionals ( 57 ). Another option that can be used after extensive resection associated with BCS is immediate autologous fat grafting ( 58 ), which can improve patient selection for EO.…”

Section: Discussionmentioning

confidence: 99%

Extreme oncoplasty: past, present and future

Vieira,

Paulinelli,

de Oliveira-Junior

2024

Front. Oncol.

Self Cite

View full text Add to dashboard Cite

Breast surgery has evolved from mastectomy to breast-conserving surgery (BCS). Breast oncoplastic surgery later emerged with the inclusion and development of techniques used in plastic surgery for breast neoplasms. Recently, a new paradigm has been considered for mastectomy candidates with large multifocal and multicentric tumours, designated extreme oncoplasty (EO), which has allowed new techniques to be applied to tumours that would have been ineligible for BCS before. There are few publications and no uniform descriptions grouping all the technical possibilities and new indications together. We performed this a review with the objective of evaluating the indications and surgeries performed in the EO context, representing a new perspective for BCS. We observed new indications as extensive microcalcifications, locally advanced breast carcinoma with partial response to chemotherapy, small to moderate-sized non-ptotic central tumours and extreme ptosis. Small breasts are able for EO since the presence of ptosis. New surgeries are reported as disguised geometric compensation, perforators flaps, local/regional flaps, latissimus dorsi miniflap and partial breast amputation. It is important to decrease barriers to oncoplastic surgery if we want to increase the use of EO and BCS rates.

show abstract

“…Such outcomes may influence QOL and breast satisfaction. Regarding the cosmetic result, it is observed that in general, patients are less demanding than health professionals, with disagreement between them regarding the quality of the results, which makes it difficult to compare cosmetic results and QOL ( 75 ).…”

Section: Discussionmentioning

confidence: 99%

Does breast oncoplastic surgery improve quality of life?

2023

Self Cite

View full text Add to dashboard Cite

Breast Oncoplastic Surgery (OS) has established itself as a safe procedure associated with the treatment of breast cancer, but the term is broad, encompassing procedures associated with breast-conserving surgeries (BCS), conservative mastectomies and fat grafting. Surgeons believe that OS is associated with an increase in quality of life (QOL), but the diversity of QOL questionnaires and therapeutic modalities makes it difficult to assess from the patient’s perspective. To answer this question, we performed a search for systematic reviews on QOL associated with different COM procedures, and in their absence, we selected case-control studies, discussing the main results. We observed that: (1) Patients undergoing BCS or breast reconstruction have improved QoL compared to those undergoing mastectomy; (2) In patients undergoing BCS, OS has not yet shown an improvement in QOL, a fact possibly influenced by patient selection bias; (3) In patients undergoing mastectomy with reconstruction, the QoL results are superior when the reconstruction is performed with autologous flaps and when the areola is preserved; (4) Prepectoral implants improves QOL in relation to subpectoral implant-based breast reconstruction; (5) ADM do not improves QOL; (6) In patients undergoing prophylactic mastectomy, satisfaction is high with the indication, but the patient must be informed about the potential complications associated with the procedure; (7) Satisfaction is high after performing fat grafting. It is observed that, in general, OS increases QOL, and when evaluating the procedures, any preservation or repair, or the use of autologous tissues, increases QOL, justifying OS.

show abstract

Oncoplastic Surgery: Does Patient and Medical Specialty Influences the Evaluation of Cosmetic Results?

Cited by 5 publications

References 36 publications

Factors associated with unsatisfactory cosmetic results in oncoplastic surgery

Factors associated with unsatisfactory cosmetic results in oncoplastic surgery

Extreme oncoplasty: past, present and future

Does breast oncoplastic surgery improve quality of life?

Contact Info

Product

Resources

About