title: Factors affecting cosmesis after breast conserving surgery without oncoplastic techniques in an experienced comprehensive breast center.
abstract: We aimed to study the factors affecting cosmetic outcome (CO) in breast conserving surgery (BCS) without oncoplastic techniques in our center with a BCS rate higher than 60% in more than 1000 breast cancer surgeries a year. In this study 284 patients who underwent BCS without oncoplastic techniques were included. Surgeries were performed by two experienced breast surgeons with more than 25 years of experience. These patients were followed in our established Wellness Clinic postoperatively. The CO is evaluated according to the "Harvard Breast Cosmesis Grading Scale" by a breast surgeon who did not participate in the patient's surgery. The correlation among patient factors (age, breast volume, menopausal status), tumor factors (size, location, distance to areola) and treatment factors (excision volume, breast skin excision, axillary surgery, adjuvant therapy) and CO were evaluated. The mean age was 57.6 [33-98] years in the successful CO group and 58.1 [34-85] years in the unsuccessful CO group (p > 0.05). The mean follow-up time was 37.9 [24-84] months. The CO was successful in 88.7% (n:252) of the patients. Tumor size, retroareolar location of the tumor, adjuvant chemotherapy administration and whole breast radiation therapy (WBRT) were correlated with a poorer CO (p < 0.05). We were able to attain a successful CO in approximately 90% of our patients. Adding oncoplastic techniques to the surgical management of larger tumors and retroareolar tumors, may increase the percentage of good CO. In selected patients choosing balloon brachytherapy instead of WBRT, may also have positive effects on CO.
authors: Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA. Electronic address: drtolgaozmen@yahoo.com.tr.
authors: Tolga
authors: T
authors: Ozmen
authors: Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors: Ahmet Veysel
authors: AV
authors: Polat
authors: Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors: Ayfer Kamali
authors: AK
authors: Polat
authors: Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors: Marguerite
authors: M
authors: Bonaventura
authors: Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors: Ronald
authors: R
authors: Johnson
authors: Magee-Womens Hospital of University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
authors: Atilla
authors: A
authors: Soran
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000601:surgery* / Q000628:therapy; D003357:Cosmetic Techniques; D005260:Female; D006782:Hospitals, Special; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods* / Q000706:statistics & numerical data; D008875:Middle Aged; D012189:Retrospective Studies
keywords: Breast cancer; Breast conserving surgery; Cosmetic outcome; Oncoplastic surgery