Oncoplastic Breast Reconstruction Complications and Patient-Reported Outcomes

Introduction: Oncoplastic breast reconstruction (OBR) combines breast conservation treatment with breast reduction/reconstruction and is appropriate for breast cancer patients with macromastia and/or ptosis, who want to avoid mastectomy, and who include breast reduction in their goals. This study's purpose was to evaluate complications and patient-reported outcomes associated with OBR at our institution. Methods: A retrospective chart review was conducted for all consecutive OBR cases from April 2009 to April 2020. Data was extracted from a prospectively maintained database and surgeons' EMRs. Risk factors for any complication were evaluated by a univariate logistic regression analysis with significance level set at P < 0.05. Postoperative patient satisfaction was evaluated with the validated BREAST-Q 2.0 questionnaire for which raw scores were obtained. Rasch-transformed scores from 0 (worst) to 100 (best) were calculated from the BREAST-Q conversion tables. Results: 81 patients had OBR of whom 22 experienced 25 post-surgical complications. Increasing ipsilateral and contralateral specimen weight and American Society of Anesthesiologists Physical Status Classification System Score (ASA) were significantly correlated with increased odds for any complication. The BREAST-Q questionnaire was completed post-OBR by 37 patients who reported a high degree of satisfaction with physicians, medical, and office staff. Conclusions: OBR is rated well by patients. All complications were Clavien-Dindo 1 and managed with local office-based wound care.