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Cosmetic sequelae after oncoplastic breast surgery: long-term results of a prospective study
Benigno Acea-Nebril1, Alejandra García-Novoa1, Carmen Cereijo-Garea1
1Breast Unit, Department of General Surgery, University Hospital Complex A Coruña, A Coruña, Spain.
Background:
To analyze risk factors for the cosmetic sequelae of patients treated with oncoplastic procedures and their impact on patient-reported satisfaction.
Methods:
Prospective nonrandomized study between 2003 and 2020. Complications and cosmetic sequelae were reported by the surgeon. We employed the Clough classification for oncoplastic procedures (Level 1 and Level 2) and to define the cosmetic sequelae (Type I, Type II and Type III). The assessment of satisfaction and quality of life was performed with the BreastQ™ questionnaire.
Results:
429 level 1 and 326 level 2 oncoplastic operations were included. We recorded 89 cosmetic sequelae: 55 deformities (type II), 29 asymmetries (type I), and 5 type III defects. The incidence of cosmetic sequelae at 10 years for levels 1 and 2 oncoplastic procedures was 11.5% and 20.0%, respectively. The level 2 techniques and the postoperative complications increased the risk of cosmetic sequelae. Patients with cosmetic sequelae did not achieve significant improvements in breast satisfaction.
Conclusions:
Cosmetic sequelae affect up to 17% of oncoplastic procedures. Most of them appear during the first 5 years. Cosmetic sequelae and their predisposing factors should be part of the shared decision-making process with patients, as well as part of the training programs for breast surgeons.
