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

Author(s):Show less -

de Oliveira-Junior, Idam ^{[1, 2]} ; Brandini da Silva, Fabiola Cristina ^{[2, 3]} ; Nazima, Flavio ^[4] ; Ribeiro, Jr., Jose Carlos ^[2] ; Castellani, Laurinda ^[5] ; Zucca-Matthes, Gustavo ^[2] ; Maciel, Maria do Socorro ^[6] ; Biller, Gabriele ^{[3, 7]} ; da Silva, Jonathas Jose ^{[2, 3]} ; Sarri, Almir Jose ^[2] ; da Costa Vieira, Rene Aloisio ^{[1, 3]}

Affiliation

^[1] Sao Paulo State Univ, Botucatu Med Sch, UNESP, Postgrad Program Tocogynecol, Sao Paulo - Brazil

^[2] Barretos Canc Hosp, Nucleous Mastol, Sao Paulo - Brazil

^[3] Barretos Canc Hosp, Postgrad Program Oncol, Sao Paulo - Brazil

^[4] Londrina Canc Hosp, Londrina, Parana - Brazil

^[5] Santa Casa Misericordia Itapeva, Canc Unit, Sao Paulo - Brazil

^[6] Oswaldo Cruz German Hosp, Sao Paulo - Brazil

^[7] FACISB Sch Med, Sao Paulo - Brazil

• Document type: Journal article
• Source: CLINICAL BREAST CANCER; v. 21, n. 3, p. 247+, JUN 2021.
• Web of Science Citations: 1

Abstract

Oncoplastic surgery (OS) has established itself as a safe treatment for breast cancer; however, its cosmetic evaluation remains little explored. After evaluating 300 patients undergoing breast-conserving treatment, with or without OS, we found that patients are more satisfied with the cosmetic outcome compared to observers (software and surgeons), and OS did not affect these results. Background: Oncoplastic surgery (OS) has added plastic surgery concepts and techniques to the breast cancer surgery. However, reports of the impact of OS on cosmesis after breast-conserving surgery (BCS) are limited in the literature. Patients and Methods: This cross-sectional prospective study included patients who underwent BCS. The patients self-evaluated the cosmetic outcome of the breasts and had them photographed. The photos were evaluated by BCCT.core software and by 6 breast surgeons (mastologists and plastic surgeons) using the Harvard, Garbay, and Fitoussi scales. Kappa and weighted kappa tests were used to analyze agreement for categorical variables; for continuous variables, the interclass correlation index and the chi-square test to analyze the association between the OS and the symmetrization. Results: A total of 300 patients were evaluated: 228 (76.0%) underwent traditional BCS and 72 (24.0%) underwent OS, and of these, 37 (51.4%) underwent contralateral symmetrization surgery. In the evaluation of the cosmetic result, the correlation between patients and observers (BCCT.core and surgeons) was weak; between the 2 groups of surgeons, the correlation was moderate (Fitoussi scale) and excellent (Garbay scale). Plastic surgeons are more critical for evaluating cosmetic results; they considered it good or excellent in 30.0% whereas patients, mastologists, and BCCT.core results considered it so in 78.8%, 34.0%, and 30.0%, respectively. In terms of cosmesis, OS and symmetrization did not influence the results in this study with long follow-up. Conclusion: Patients' self-evaluation reported better cosmesis than surgeons' analyses. Plastic surgeons were the most critical. OS and symmetrization did not influence the results. (C) 2020 Elsevier Inc. All rights reserved. (AU)

• FAPESP's process: 14/08197-0 - Conservative treatment of breast cancer: validation of tools for qualitative and quantitative evaluation
• Grantee: René Aloisio da Costa Vieira
• Support Opportunities: Regular Research Grants