Clinical Scorecard: Aesthetic Results of Oncoplastic Surgery in Breast Cancer Patients: Insights from an Eleven-Year Study Across Two Tertiary Centers

At a Glance

Key Highlights

• Median cosmetic scores for type I and type II oncoplastic surgery (OPS) were similar (score of 8), with no significant difference in overall aesthetic outcomes.
• Specific OPS techniques such as round block, lateral perforator flap, bilateral mammoplasty, and racquet techniques yielded superior cosmetic results compared to the batwing technique.
• Nipple-areolar complex position was significantly associated with the type of OPS technique used, influencing aesthetic outcomes.

Guideline-Based Recommendations

Diagnosis

• Assess tumor size and location to guide selection of appropriate oncoplastic surgery technique.

Management

• Utilize a surgical algorithm incorporating tumor characteristics to select OPS techniques that optimize aesthetic outcomes.
• Consider round block, lateral perforator flap, bilateral mammoplasty, or racquet techniques for better cosmetic results when feasible.

Monitoring & Follow-up

• Evaluate cosmetic outcomes at six months post-radiotherapy using standardized scales such as the Harvard scale and objective scoring by expert committees.

Risks

• Be aware that certain techniques like the batwing approach may yield less favorable cosmetic outcomes.
• Monitor nipple-areolar complex position postoperatively as it correlates with aesthetic success.

Patient & Prescribing Data

Breast cancer patients undergoing oncoplastic breast-conserving surgery

Both type I and type II OPS techniques provide acceptable aesthetic outcomes; choice of specific technique should consider tumor location, size, and potential impact on nipple-areolar complex positioning.

Clinical Best Practices

• Apply a quadrant-based surgical algorithm to tailor OPS technique selection according to tumor location and size.
• Use validated cosmetic assessment tools such as the Harvard scale and objective scoring systems for postoperative evaluation.
• Prioritize OPS techniques demonstrated to have superior cosmetic outcomes, including round block and lateral perforator flap methods.
• Ensure multidisciplinary collaboration including plastic surgeons for optimal aesthetic and oncological results.

References

• Farouk O et al. (2015) Outcome of oncoplastic techniques in defect reconstruction after resection of central breast tumors. World J Surg Oncol
• Clough KB et al. (1995) Conservative treatment of breast cancers by mammaplasty and irradiation: a new approach to lower quadrant tumors. Plast Reconstr Surg
• Clough KB et al. (2010) Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery. Ann Surg Oncol
• Pillarisetti RR et al. (2012) Oncoplastic breast surgery. Indian J Surg
• Cantürk NZ et al. (2021) Oncoplastic Breast-Conserving surgery according to tumor location. Eur J Breast Health
• Chan SW et al. (2010) Cosmetic outcome and percentage of breast volume excision in oncoplastic breast conserving surgery. World J Surg
• Clough KB et al. (2012) Oncoplastic surgery for breast cancer based on tumour location and a quadrant-per-quadrant atlas. Br J Surg
• Harris JR et al. (1979) Analysis of cosmetic results following primary radiation therapy for stages I and II carcinoma of the breast. Int J Radiat Oncol Biol Phys