title: Evaluation of factors impacting cosmetic outcome of breast conservative surgery--a study in Iran.
abstract: BACKGROUND
  Breast conservative surgery (BCS) followed by radiotherapy is the standard approach in management of stage I-II breast cancer. Several factors can affect cosmetic outcomes. The aim of this study was to evaluate the cosmetic results of BCS and influencing factors in the Iranian Breast Cancer Research Center.
  
  
  METHODS
  Patients who had undergone BCS were included. Photographs were taken of both breasts of the patients in three aspects and were evaluated by three specialists. The cosmetic scores were calculated based on a standard questionnaire. The data were analyzed using univariate and multivariate regression for relationships between cosmetic scores and clinical data.
  
  
  RESULTS
  A total number of 103 patients were included in the study. Mean age and BMI of the patients were 46.8±8.9 and 28.1±3.9, respectively. Breast cup sizes C and D accounted for 74.7% of the study group. The mean cosmetic score obtained from three referees was 5.72+2.06, consisting of 35.9% excellent-good, 35% moderate, and 29.1% unsatisfactory results. Patient BMI, volume of the resected tissue and breast cup size (D) showed significant correlation with the cosmetic score. On multivariate regression analysis, cosmetic score and BMI (p=0.022,) as well as breast cup size (p=0.040), remained significant.
  
  
  CONCLUSIONS
  Immediate or delayed symmetrization of the breasts is suggested during breast conservative surgery, meanwhile performing oncoplastic techniques to improve the results significantly. Also it is suggested to discuss anticipation of less satisfactory results with patients having higher BMI and large breast cup size.
authors.affiliation: Breast Diseases Research Group, Breast Cancer Research Center, ACECR, Tehran, Iran E-mail : Folfatbakhsh@yahoo.com.
authors.forename: Asiie
authors.initials: A
authors.lastname: Olfatbakhsh
authors.forename: Neda
authors.initials: N
authors.lastname: Mehrdad
authors.forename: Mandana
authors.initials: M
authors.lastname: Ebrahimi
authors.forename: Nasrin
authors.initials: N
authors.lastname: Alavi
authors.forename: Esmat
authors.initials: E
authors.lastname: Hashemi
authors.forename: Ahmad
authors.initials: A
authors.lastname: Kaviani
authors.forename: Masoume
authors.initials: M
authors.lastname: Najafi
authors.forename: Shahpar
authors.initials: S
authors.lastname: Haghighat
authors.forename: Saeed
authors.initials: S
authors.lastname: Arefanian
mesh_terms: D000328:Adult; D000368:Aged; D001828:Body Image; D001943:Breast Neoplasms / Q000473:pathology / Q000523:psychology / Q000601:surgery*; D003430:Cross-Sectional Studies; D004954:Esthetics; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007492:Iran; D016462:Mammaplasty / Q000379:methods*; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis