Clinical Report: Aesthetic Outcomes of Oncoplastic Breast Surgery Over Eleven Years

Overview

This eleven-year observational study of 494 breast cancer patients assessed the cosmetic outcomes of various oncoplastic surgery (OPS) techniques using the Harvard scale and an objective scoring system. Results showed comparable median cosmetic scores between type I and type II OPS, with certain techniques like the round block yielding superior aesthetic results.

Background

Oncoplastic surgery integrates oncological safety with aesthetic breast conservation in breast cancer treatment. Despite its growing use, comparative evidence on cosmetic outcomes among different OPS techniques remains limited. This study evaluates aesthetic results post-OPS to guide surgical decision-making. Cosmetic outcomes were assessed six months after radiotherapy by expert committees and plastic surgeons.

Data Highlights

Key Findings

• Median cosmetic scores were equal (8) for both type I and type II OPS techniques.
• Type II OPS scored one point lower than type I in the lowest quartile of cosmetic scores.
• Harvard scale ratings showed no significant difference between type I and II OPS (P = 0.124).
• Round block, lateral perforator flap, bilateral mammoplasty, and racquet techniques had significantly better cosmetic outcomes than the batwing technique (P < 0.05).
• There was a significant association between nipple-areolar complex position and OPS technique (P = 0.013).
• The surgical algorithm used enabled acceptable aesthetic results regardless of tumor size and location.

Clinical Implications

Surgeons can expect generally favorable aesthetic outcomes with both type I and II OPS techniques, but should consider specific approaches like the round block technique for superior cosmetic results. The batwing technique may yield less favorable aesthetics and should be selected cautiously. Attention to nipple-areolar complex positioning is important for optimizing outcomes.

Conclusion

This study supports the use of a structured surgical algorithm in OPS to achieve acceptable cosmetic outcomes across tumor sizes and locations, highlighting the round block technique as particularly effective among type II procedures. These findings inform surgical planning to balance oncological safety with aesthetic goals.

References

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3. Clough KB et al. 2010 -- Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery
4. Cantürk NZ et al. 2021 -- Oncoplastic Breast-Conserving surgery according to tumor location
5. Harris JR et al. 1979 -- Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast