Cosmetic Outcomes and Symmetry Comparison in Patients Undergoing Bilateral Therapeutic Mammoplasty for Breast Cancer

• Published in: World journal of surgery Vol. 45; no. 5; pp. 1433 - 1441
• Main Authors: Gulis, K., Rydén, L., Bendahl, P. O., Svensjö, T.
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01.05.2021; Springer Nature B.V
• Subjects: Abdominal Surgery; Asymmetry; Breast cancer; Breast surgery; Cardiac Surgery; Clinical Medicine; Correlation analysis; Evaluation; General Surgery; Kirurgi; Klinisk medicin; Medical and Health Sciences; Medicin och hälsovetenskap; Medicine; Medicine & Public Health; Original Scientific Report; Patients; Surgeons; Surgery; Symmetry; Thoracic Surgery; Tumors; Vascular Surgery
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-020-05941-0

Background Breast-reduction techniques are increasingly used in oncoplastic breast surgery. Bilateral therapeutic mammoplasty has the benefit of decreasing breast volume, enabling resection of larger tumors, and the potential to assure good postoperative symmetry. The aims of this study were to objectively asses the cosmetic outcomes of therapeutic mammoplasty in patients with breast cancer, using the breast cancer conservative treatment cosmetic results (BCCT.core) software, to compare this score with the surgeon’s score and the patient’s assessment, and to evaluate if other defined parameters have an impact on cosmetic outcomes. The secondary aim was to compare breast symmetry pre- and postoperatively. Materials and Methods We enrolled 146 consecutive patients with primary breast cancer who underwent therapeutic mammoplasty between 2011 and 2018 in Kristianstad Central Hospital, Sweden. We retrospectively collected data from patients’ records. We analyzed the BCCT.core score using postoperative photographs to objectively evaluate cosmetic outcomes on a four-grade scale and compared with preoperative photographs to evaluate symmetry. Cosmetic outcomes were also assessed subjectively by patients and surgeons, using a 10-point Likert scale. Results The majority of patients (89%) had good or excellent BCCT.core scores, which correlated with surgeons’ scores, rs =  − 0.22 ( p  < 0.001). Overall, patients were more satisfied with the cosmetic outcomes than the surgeons ( p  < 0.001). Evidence supporting an association between the defined clinicopathological variables, for example, tumor size, and cosmetic outcomes, was weak. Conclusion Therapeutic mammoplasty yields a very good cosmetic outcome, evaluated both by subjective and objective measurements. Importantly, symmetry can be improved in patients with asymmetry.