BACKGROUND AND OBJECTIVES:
The aim of this study was to explore features of patients reporting early poor aesthetic outcome after simple breast-conserving surgery.
METHODS:
We prospectively evaluated 709 patients shortly after breast-conserving surgery. Aesthetic outcome was measured by aesthetic status scores of the Breast Cancer Treatment Outcome Scale. Clinical, surgical, and pathologic variables were assessed to identify predictors of poor aesthetic outcome.
RESULTS:
Poor aesthetic outcome was reported by 46 (6.5%) patients, and 209 (29%) patients reported an intermediate aesthetic outcome. A single factor analysis of variance showed a negative impact of higher specimen weight (P < 0.001). Univariate logistic regression analysis revealed the following significant risk factors for poor aesthetic outcome: 12 o'clock positioning of tumor localization, a tumor behind the nipple areolar complex (NAC), fishmouth-shaped incision with resection of the NAC, quadrantectomy, central segmental resection, and pT stages 3 and 4. Multivariate logistic regression analysis indicated statistically independent associations between poor aesthetic outcome and tumor position in the inner half of the breast or behind the NAC, quadrantectomy, and pT stages 3 and 4.
CONCLUSION:
Poor aesthetic outcome is relatively rare shortly after breast-conserving surgery, but predictable in specific situations.
