title: Systematization of Oncoplastic Surgery: Selection of Surgical Techniques and Patient-Reported Outcome in a Cohort of 1,035 Patients.
abstract: BACKGROUND
  Functional and aesthetic outcome after breast-conserving surgery are vital endpoints for patients with primary breast cancer. A large variety of oncoplastic techniques exist; however, it remains unclear which techniques yield the highest rates of local control at first surgery, omission of reexcision or subsequent mastectomy, and merits the highest degree of patient satisfaction.
  
  
  METHODS
  In this retrospective case cohort trial with a customized investigational questionnaire for assessment of patient satisfaction with the surgical result, we analyzed 1,035 patients with primary, unilateral breast cancer and oncoplastic surgery from 2004 to 2009.
  
  
  RESULTS
  Analysis of patient reported outcome (PRO) revealed that 88 % of the cohort was satisfied with their aesthetic result using oncoplastic techniques following the concept presented. These results also were achieved in difficult tumor localizations, such as upper inner and lower inner quadrant. Conversion rate from breast-conserving therapy to secondary mastectomy was low at 7.2 % (n = 68/944 patients). The systematization of oncoplastic techniques presented-embedded in a multimodal concept of breast cancer therapy-facilitates tumor control with a few number of uncomplicated techniques adapted to tumor site and size with a median resection of 32 (range 11-793) g. Five-year recurrence rate in our cohort was 4.0 %.
  
  
  CONCLUSIONS
  Patient's satisfaction was independent from age, body mass index, resection volume, tumor localization, and type of oncoplastic surgery (p > 0.05). We identified postoperative pain as an important negative impact factor on patient's satisfaction with the aesthetic result (p = 0.0001).
authors: Breast Unit, Breast Center Düsseldorf Luisenkrankenhaus, Düsseldorf, Germany.
authors: Mahdi
authors: M
authors: Rezai
authors: Breast Unit, Breast Center Düsseldorf Luisenkrankenhaus, Düsseldorf, Germany.|Women's Department, University Hospital of Essen, Essen, Germany.
authors: Sarah
authors: S
authors: Knispel
authors: Breast Unit, Breast Center Düsseldorf Luisenkrankenhaus, Düsseldorf, Germany.|Women's Department, University Hospital of Essen, Essen, Germany.
authors: Stephanie
authors: S
authors: Kellersmann
authors: Institute of Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany.
authors: Hildegard
authors: H
authors: Lax
authors: Women's Department, University Hospital of Essen, Essen, Germany.
authors: Rainer
authors: R
authors: Kimmig
authors: Breast Unit, Breast Center Düsseldorf Luisenkrankenhaus, Düsseldorf, Germany. Peter.Kern@uk-essen.de.|Women's Department, University Hospital of Essen, Essen, Germany. Peter.Kern@uk-essen.de.
authors: Peter
authors: P
authors: Kern
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000473:pathology / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000009:adverse effects / Q000379:methods*; D008488:Medical Illustration; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009929:Organ Size; D010149:Postoperative Pain / Q000209:etiology / Q000523:psychology; D017060:Patient Satisfaction; D012086:Reoperation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D047368:Tumor Burden