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The cosmetic outcome in early breast cancer treated with breast conservation
S K Al-Ghazal1, R W Blamey, J Stewart
1Breast Unit, Nottingham City Hospital, Nottingham, UK.
Aims:
To measure the cosmetic outcome of breast-conserving surgery and identify the factors which influence cosmesis.
Methods:
A total of 254 patients with primary breast cancer treated by wide local excision, with or without radiotherapy, were subjectively assessed for cosmesis by a six-member panel using photographic evaluation and objectively by an independent observer using specific measurement.
Results:
Good to excellent cosmetic results were achieved in 184 (72%) patients on panel subjective assessment and 201 (79%) patients on objective assessment. Good correlation (P<0.001) and agreement were found between the panel's subjective photographic assessment and the objective assessment. The main factors found to affect cosmesis negatively were: medially located tumours; weight of specimen; re-excision procedures; radiotherapy; small breasts and longer scars.
Conclusion:
These cosmetic results, combined with a low local recurrence rate following wide local excision, validate the operative method used.