BACKGROUND: Although breast-conserving surgery is the standard of care for early-stage breast cancer, many women report breast asymmetry after this procedure. Risk factors for poor esthetic outcomes are not well understood. STUDY DESIGN: A self-administered survey was sent to patients who underwent lumpectomy (n = 898) at the University of Michigan Medical Center between January 2002 and May 2006 (n = 714, response rate = 79.5%). Breast asymmetry was assessed using items from the Breast Cancer Treatment and Outcomes Survey. Responses were summed to generate a score, and linear regression was used to generate adjusted breast asymmetry scores by patient-related factors (age, body mass index [BMI], tumor size, and tumor position in the breast) and treatment factors (reexcision lumpectomy, radiation therapy, and postoperative seroma). RESULTS: Patient-related risk factors for breast asymmetry included younger age (asymmetry score: 18.7 versus 16.2, p = 0.03), higher BMI (17.1 versus 19.2, p = 0.007), and larger tumors (16.7 versus 19.1, p = 0.01). Resection of superior medial tumors and inferior lateral tumors was also associated with substantially higher asymmetry. Treatment-related risk factors for asymmetry included reexcision lumpectomy (18.1 versus 16.9, p = 0.013), postoperative seroma (19.3 versus 17.2, p = 0.005), and radiation therapy (17.9 versus 15.0, p = 0.008). Increasing breast asymmetry score was associated with a higher odds of desiring breast reconstruction (odds ratio = 1.2, 95% CI, 1.13 to 1.30). CONCLUSIONS: Both patient- and treatment-related factors place women at risk for poor esthetic outcomes after breast-conserving surgery. Oncoplastic and reconstructive options should be considered for those at a higher risk for poor esthetic outcomes at the time of consultation.
BACKGROUND: Although breast-conserving surgery is the standard of care for early-stage breast cancer, many women report breast asymmetry after this procedure. Risk factors for poor esthetic outcomes are not well understood. STUDY DESIGN: A self-administered survey was sent to patients who underwent lumpectomy (n = 898) at the University of Michigan Medical Center between January 2002 and May 2006 (n = 714, response rate = 79.5%). Breast asymmetry was assessed using items from the Breast Cancer Treatment and Outcomes Survey. Responses were summed to generate a score, and linear regression was used to generate adjusted breast asymmetry scores by patient-related factors (age, body mass index [BMI], tumor size, and tumor position in the breast) and treatment factors (reexcision lumpectomy, radiation therapy, and postoperative seroma). RESULTS:Patient-related risk factors for breast asymmetry included younger age (asymmetry score: 18.7 versus 16.2, p = 0.03), higher BMI (17.1 versus 19.2, p = 0.007), and larger tumors (16.7 versus 19.1, p = 0.01). Resection of superior medial tumors and inferior lateral tumors was also associated with substantially higher asymmetry. Treatment-related risk factors for asymmetry included reexcision lumpectomy (18.1 versus 16.9, p = 0.013), postoperative seroma (19.3 versus 17.2, p = 0.005), and radiation therapy (17.9 versus 15.0, p = 0.008). Increasing breast asymmetry score was associated with a higher odds of desiring breast reconstruction (odds ratio = 1.2, 95% CI, 1.13 to 1.30). CONCLUSIONS: Both patient- and treatment-related factors place women at risk for poor esthetic outcomes after breast-conserving surgery. Oncoplastic and reconstructive options should be considered for those at a higher risk for poor esthetic outcomes at the time of consultation.
Authors: Benjamin D Smith; Xiudong Lei; Kevin Diao; Ying Xu; Yu Shen; Grace L Smith; Sharon H Giordano; Sarah M DeSnyder; Kelly K Hunt; Mediget Teshome; Reshma Jagsi; Simona F Shaitelman; Susan K Peterson; Cameron W Swanick Journal: Ann Surg Oncol Date: 2020-01-08 Impact factor: 5.344
Authors: Max Dieterich; Sophie Allmendinger; Bernd Gerber; Toralf Reimer; Steffi Hartmann; Angrit Stachs; Johannes Stubert Journal: Breast Care (Basel) Date: 2020-12-30 Impact factor: 2.860
Authors: V Acosta-Marin; V Acosta-Freites; A Contreras; R Ravelo; G Fuenmayor; C Marin; A Ramirez; M Acosta-Marin; J Perez-Fuentes; I Longobardi; H Esteves Journal: Ecancermedicalscience Date: 2014-10-14
Authors: Ahmad Kaviani; Nassim Sodagari; Sara Sheikhbahaei; Vahid Eslami; Nima Hafezi-Nejad; Amin Safavi; Maryam Noparast; Alfred Fitoussi Journal: ISRN Oncol Date: 2013-09-12