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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2023

09-08-2023 | Breast Surgery | Breast Oncology

Long-Term Patient-Reported Outcomes Comparing Oncoplastic Breast Surgery and Conventional Breast-Conserving Surgery: A Propensity Score-Matched Analysis

Authors: Linda M. Pak, MD, Regina Matar-Ujvary, MD, Francys C. Verdial, MD, MPH, Kathryn A. Haglich, MS, Varadan Sevilimedu, MBBS, DrPH, Jonas A. Nelson, MD, MPH, Mary L. Gemignani, MD, MPH

Published in: Annals of Surgical Oncology | Issue 12/2023

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Abstract

Introduction

Oncoplastic breast surgery (OBS) combines plastic surgery techniques with conventional breast-conserving surgery (BCS) and expands BCS eligibility. Limited data are available on patient-reported outcomes (PROs) after OBS. Here we compare long-term PROs after OBS and BCS utilizing the BREAST-Q.

Patients and Methods

Women undergoing OBS or BCS between 2006 and 2019 who completed ≥ 1 long-term BREAST-Q survey 3–5 years postoperatively were identified. Baseline characteristics were compared between women who underwent OBS/BCS. Women who underwent OBS were paired with those who underwent BCS using 1:2 propensity matching [by age, body mass index (BMI), race, T stage, and multifocality]. BREAST-Q scores were compared preoperatively and 3–5 years postoperatively.

Results

A total of 297 patients were included for analysis (99 OBS/198 BCS). Women who underwent OBS were younger (p < 0.001) and had higher BMI (p = 0.005) and multifocal disease incidence (p = 0.004). There was no difference between groups in nodal stage, re-excision rates, axillary surgery, chemotherapy, endocrine therapy, or radiotherapy. After propensity matching preoperatively, women who underwent OBS reported lower psychosocial well-being (63 versus 100, p = 0.039) but similar breast satisfaction and sexual well-being compared with women who underwent BCS; however, only three patients who underwent BCS had preoperative BREAST-Q scores available for review. In long-term follow-up, women who underwent OBS reported lower psychosocial scores (74 versus 93, p = 0.011) 4 years postoperatively, but not at 5 years (76 versus 77, p = 0.83). There was no difference in long-term breast satisfaction or sexual well-being.

Conclusions

Women who undergo OBS present with a larger disease burden and may represent a group of non-traditional BCS candidates; they reported similar long-term breast satisfaction and sexual well-being compared with women who undergo BCS. While women who underwent OBS reported lower psychosocial well-being scores preoperatively and during a portion of the follow-up period, this difference was no longer seen at 5 years postoperatively.
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Metadata
Title
Long-Term Patient-Reported Outcomes Comparing Oncoplastic Breast Surgery and Conventional Breast-Conserving Surgery: A Propensity Score-Matched Analysis
Authors
Linda M. Pak, MD
Regina Matar-Ujvary, MD
Francys C. Verdial, MD, MPH
Kathryn A. Haglich, MS
Varadan Sevilimedu, MBBS, DrPH
Jonas A. Nelson, MD, MPH
Mary L. Gemignani, MD, MPH
Publication date
09-08-2023
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 12/2023
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-023-13962-x

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