Long-term objective esthetic outcome after breast-conserving therapy

Area of Science:

• Oncology
• Plastic Surgery
• Medical Imaging

Background:

• Assessing long-term aesthetic outcomes (AO) post-breast-conserving surgery (BCS) is vital for patient counseling.
• Objective evaluation of AO using validated software is essential for understanding treatment impacts.

Purpose of the Study:

• To analyze factors influencing AO improvement and impairment over time after BCS.
• To identify predictors of unfavorable long-term AO and characterize patient groups with changing outcomes.

Main Methods:

• Analysis of a prospective cohort using BCCT.core software to assess AO at baseline, short-term, and 3-year follow-up.
• Logistic regression analysis to identify influencing factors on AO.
• Characterization of patient groups with improving or worsening AO.

Main Results:

• Predictors of unfavorable AO include axillary lymphadenectomy, tumor location (12 o'clock), advanced tumor stage ((y)pT2+), and high specimen weight (>75g).
• Lower specimen weight correlated with improved long-term AO, while higher tumor stage predicted impairment.
• Despite an overall decrease in AO, nearly half of patients with initial unfavorable outcomes showed improvement by 3 years.

Conclusions:

• Preoperative identification of unfavorable AO predictors can inform patient counseling and surgical planning (e.g., oncoplastic techniques).
• Understanding dynamic changes in AO aids in managing patient expectations and post-surgical consultations.