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Systematization of Oncoplastic Surgery: Selection of Surgical Techniques and Patient-Reported Outcome in a Cohort of 1,035 Patients.

Rezai M, Knispel S, Kellersmann S, Lax H, Kimmig R, Kern P - Ann. Surg. Oncol. (2015)

Bottom Line: These results also were achieved in difficult tumor localizations, such as upper inner and lower inner quadrant.Five-year recurrence rate in our cohort was 4.0 %.We identified postoperative pain as an important negative impact factor on patient's satisfaction with the aesthetic result (p = 0.0001).

View Article: PubMed Central - PubMed

Affiliation: Breast Unit, Breast Center Düsseldorf Luisenkrankenhaus, Düsseldorf, Germany.

ABSTRACT

Introduction: Functional and aesthetic outcome after breast-conserving surgery are vital endpoints for patients with primary breast cancer. A large variety of oncoplastic techniques exist; however, it remains unclear which techniques yield the highest rates of local control at first surgery, omission of reexcision or subsequent mastectomy, and merits the highest degree of patient satisfaction.

Methods: In this retrospective case cohort trial with a customized investigational questionnaire for assessment of patient satisfaction with the surgical result, we analyzed 1,035 patients with primary, unilateral breast cancer and oncoplastic surgery from 2004 to 2009.

Results: Analysis of patient reported outcome (PRO) revealed that 88 % of the cohort was satisfied with their aesthetic result using oncoplastic techniques following the concept presented. These results also were achieved in difficult tumor localizations, such as upper inner and lower inner quadrant. Conversion rate from breast-conserving therapy to secondary mastectomy was low at 7.2 % (n = 68/944 patients). The systematization of oncoplastic techniques presented-embedded in a multimodal concept of breast cancer therapy-facilitates tumor control with a few number of uncomplicated techniques adapted to tumor site and size with a median resection of 32 (range 11-793) g. Five-year recurrence rate in our cohort was 4.0 %.

Conclusions: Patient's satisfaction was independent from age, body mass index, resection volume, tumor localization, and type of oncoplastic surgery (p > 0.05). We identified postoperative pain as an important negative impact factor on patient's satisfaction with the aesthetic result (p = 0.0001).

No MeSH data available.


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Selection of oncoplastic techniques
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Fig2: Selection of oncoplastic techniques

Mentions: The selection of an oncoplastic technique presented follows a nomogram that we adapted to the tumor localization, tumor size, and the volume of the breast. The different choices of techniques are displayed in Fig. 2.Fig. 2


Systematization of Oncoplastic Surgery: Selection of Surgical Techniques and Patient-Reported Outcome in a Cohort of 1,035 Patients.

Rezai M, Knispel S, Kellersmann S, Lax H, Kimmig R, Kern P - Ann. Surg. Oncol. (2015)

Selection of oncoplastic techniques
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4565865&req=5

Fig2: Selection of oncoplastic techniques
Mentions: The selection of an oncoplastic technique presented follows a nomogram that we adapted to the tumor localization, tumor size, and the volume of the breast. The different choices of techniques are displayed in Fig. 2.Fig. 2

Bottom Line: These results also were achieved in difficult tumor localizations, such as upper inner and lower inner quadrant.Five-year recurrence rate in our cohort was 4.0 %.We identified postoperative pain as an important negative impact factor on patient's satisfaction with the aesthetic result (p = 0.0001).

View Article: PubMed Central - PubMed

Affiliation: Breast Unit, Breast Center Düsseldorf Luisenkrankenhaus, Düsseldorf, Germany.

ABSTRACT

Introduction: Functional and aesthetic outcome after breast-conserving surgery are vital endpoints for patients with primary breast cancer. A large variety of oncoplastic techniques exist; however, it remains unclear which techniques yield the highest rates of local control at first surgery, omission of reexcision or subsequent mastectomy, and merits the highest degree of patient satisfaction.

Methods: In this retrospective case cohort trial with a customized investigational questionnaire for assessment of patient satisfaction with the surgical result, we analyzed 1,035 patients with primary, unilateral breast cancer and oncoplastic surgery from 2004 to 2009.

Results: Analysis of patient reported outcome (PRO) revealed that 88 % of the cohort was satisfied with their aesthetic result using oncoplastic techniques following the concept presented. These results also were achieved in difficult tumor localizations, such as upper inner and lower inner quadrant. Conversion rate from breast-conserving therapy to secondary mastectomy was low at 7.2 % (n = 68/944 patients). The systematization of oncoplastic techniques presented-embedded in a multimodal concept of breast cancer therapy-facilitates tumor control with a few number of uncomplicated techniques adapted to tumor site and size with a median resection of 32 (range 11-793) g. Five-year recurrence rate in our cohort was 4.0 %.

Conclusions: Patient's satisfaction was independent from age, body mass index, resection volume, tumor localization, and type of oncoplastic surgery (p > 0.05). We identified postoperative pain as an important negative impact factor on patient's satisfaction with the aesthetic result (p = 0.0001).

No MeSH data available.


Related in: MedlinePlus