Do reexcisions impair aesthetic outcome in breast conservation surgery? Exploratory analysis of a prospective cohort study
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Do reexcisions impair aesthetic outcome in breast conservation surgery? Exploratory analysis of a prospective cohort study. / Heil, Joerg; Breitkreuz, Kathrin; Golatta, Michael; Czink, Elena; Dahlkamp, Julia; Rom, Joachim; Schuetz, Florian; Blumenstein, Maria; Rauch, Geraldine; Sohn, Christof.
in: ANN SURG ONCOL, Jahrgang 19, Nr. 2, 02.2012, S. 541-547.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Do reexcisions impair aesthetic outcome in breast conservation surgery? Exploratory analysis of a prospective cohort study
AU - Heil, Joerg
AU - Breitkreuz, Kathrin
AU - Golatta, Michael
AU - Czink, Elena
AU - Dahlkamp, Julia
AU - Rom, Joachim
AU - Schuetz, Florian
AU - Blumenstein, Maria
AU - Rauch, Geraldine
AU - Sohn, Christof
PY - 2012/2
Y1 - 2012/2
N2 - PURPOSE: Reexcision is a clinically relevant aspect of oncological breast conservation surgery. The influence of reexcision on aesthetic outcome is described differently in the literature. Our aim was to analyze this question in a well-defined cohort with standardized study instruments.METHODS: A total of 439 patients from a prospectively followed cohort were included in this analysis. Aesthetic results were assessed by the Breast Cancer Treatment Outcome Scale (BCTOS) aesthetic status. Dates of assessments were shortly after surgical interventions and before surgery. Group comparison was performed between patients with reexcisions (80 cases; 18%) and patients without reexcision (359 cases; 82%). We considered variables of differing distribution between the two groups that could hypothetically influence BCTOS aesthetic status in a nonparametric analysis of covariance (ANCOVA).RESULTS: The aesthetic status of patients with reexcisions was found to be significantly worse than for patients with a single breast conservation surgery (P < 0.0001) when tested by a nonparametric ANCOVA model. Because patients with reexcisions had more noninvasive tumors (25% vs. 8%, P = 0.0001) and tumors were larger in patients with reexcision (P = 0.01), we included these variables as possible covariates in the multivariate model. The model was adjusted for the BCTOS aesthetic status before and shortly after the first surgery.CONCLUSIONS: Our findings suggest that reexcision in breast conservation surgery impairs aesthetic outcome, at least when assessed shortly after surgery.
AB - PURPOSE: Reexcision is a clinically relevant aspect of oncological breast conservation surgery. The influence of reexcision on aesthetic outcome is described differently in the literature. Our aim was to analyze this question in a well-defined cohort with standardized study instruments.METHODS: A total of 439 patients from a prospectively followed cohort were included in this analysis. Aesthetic results were assessed by the Breast Cancer Treatment Outcome Scale (BCTOS) aesthetic status. Dates of assessments were shortly after surgical interventions and before surgery. Group comparison was performed between patients with reexcisions (80 cases; 18%) and patients without reexcision (359 cases; 82%). We considered variables of differing distribution between the two groups that could hypothetically influence BCTOS aesthetic status in a nonparametric analysis of covariance (ANCOVA).RESULTS: The aesthetic status of patients with reexcisions was found to be significantly worse than for patients with a single breast conservation surgery (P < 0.0001) when tested by a nonparametric ANCOVA model. Because patients with reexcisions had more noninvasive tumors (25% vs. 8%, P = 0.0001) and tumors were larger in patients with reexcision (P = 0.01), we included these variables as possible covariates in the multivariate model. The model was adjusted for the BCTOS aesthetic status before and shortly after the first surgery.CONCLUSIONS: Our findings suggest that reexcision in breast conservation surgery impairs aesthetic outcome, at least when assessed shortly after surgery.
KW - Breast Neoplasms
KW - Carcinoma, Ductal, Breast
KW - Carcinoma, Intraductal, Noninfiltrating
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Mastectomy, Segmental
KW - Middle Aged
KW - Neoplasm Invasiveness
KW - Prospective Studies
KW - Reoperation
KW - Surgery, Plastic
KW - Treatment Outcome
KW - Clinical Trial
KW - Journal Article
U2 - 10.1245/s10434-011-1947-1
DO - 10.1245/s10434-011-1947-1
M3 - SCORING: Journal article
C2 - 21761099
VL - 19
SP - 541
EP - 547
JO - ANN SURG ONCOL
JF - ANN SURG ONCOL
SN - 1068-9265
IS - 2
ER -