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

Y L Blok; P S Verduijn; L U M Corion; J M Visser; C C van der Pol; J A van der Hage; M A M Mureau; N M A Krekel

doi:10.1016/j.bjps.2022.06.088

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

J Plast Reconstr Aesthet Surg. 2022 Nov;75(11):4152-4159. doi: 10.1016/j.bjps.2022.06.088. Epub 2022 Jun 26.

Authors

Y L Blok¹, P S Verduijn², L U M Corion³, J M Visser², C C van der Pol⁴, J A van der Hage⁵, M A M Mureau⁶, N M A Krekel³

Affiliations

¹ Department of Plastic and Reconstructive surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands. Electronic address: y.l.blok@lumc.nl.
² Department of Plastic and Reconstructive surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands.
³ Department of Plastic and Reconstructive surgery, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, the Netherlands; Department of Plastic and Reconstructive surgery, Alrijne Ziekenhuis, Leiderdorp, the Netherlands.
⁴ Department of Surgical Oncology, Alrijne Ziekenhuis, Leiderdorp, the Netherlands.
⁵ Department of Surgical Oncology, Leiden University Medical Center, Leiden, the Netherlands.
⁶ Department of Plastic and Reconstructive surgery, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, the Netherlands.

PMID: 36171174
DOI: 10.1016/j.bjps.2022.06.088

Abstract

Introduction: This study aimed to evaluate complication rates, patient satisfaction, 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 outcomes were assessed by patient self-evaluation and panel evaluation based on medical photographs.

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. Following 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 symmetry." 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 comparable results. Expected differences in physical discomfort and symmetry between both techniques were observed. In addition, the occurrence of complications resulted in lower patient satisfaction and cosmetic outcomes. These findings emphasize the importance of thorough preoperative counselling.

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

MeSH terms

Breast Neoplasms* / surgery
Female
Humans
Mammaplasty* / adverse effects
Mammaplasty* / methods
Mastectomy
Mastectomy, Segmental / adverse effects
Mastectomy, Segmental / methods
Patient Satisfaction
Prospective Studies