Ann Surg Treat Res.  2016 Mar;90(3):117-123. 10.4174/astr.2016.90.3.117.

Long-term results of oncoplastic breast surgery with latissimus dorsi flap reconstruction: a pilot study of the objective cosmetic results and patient reported outcome

• Kim KD
• Kim Z
• Kuk JC
• Jeong J
• Choi KS
• Hur SM
• Jeong GA
• Chung JC
• Cho GS
• Shin EJ
• Kim HC
• Kang SG
• Lee MH
• Lim CW

• KMID: 2155044
• DOI: http://doi.org/10.4174/astr.2016.90.3.117

Abstract

PURPOSE
The goal of oncoplastic breast surgery is to restore the appearance of the breast and improve patient satisfaction. Thus, the assessment of cosmetic results and patient-reported outcomes (PROs) using appropriately constructed and validated instruments is essential. The aim of the present study was to assess the long-term objective cosmetic results and corresponding PROs after oncoplastic breast surgery.
METHODS
Cosmetic results were assessed by the patients, a medical panel, and a computer program (BCCT.core). PROs were assessed using BREAST-Q, a questionnaire that measures the perception of patients having breast surgery. The cosmetic results and PROs were analyzed in patients who underwent quadrantectomy and partial breast reconstruction utilizing the latissimus dorsi flap.
RESULTS
The mean duration of the follow-up period was 91.6 months (range, 33.3-171.0 months), and mean age of the patients was 51 years old (range, 33-72 years). The mean tumor size was 2.1 cm (range, 0.9-5.5 cm). There was fair agreement between the medical panel and BCCT.core score (K = 0.32, P < 0.001), and a statistically significant correlation between the BCCT.core score and medical panel cosmetic results was identified (r = 0.606, P < 0.001). A better BCCT.core result was related to a higher PRO of each BREAST-Q domain-satisfaction with breasts (R2 = 0.070, P = 0.039), satisfaction with outcome (R2 = 0.087, P = 0.021), psychosocial well-being (R2 = 0.085, P = 0.023), sexual well-being (R2 = 0.082, P = 0.029), and satisfaction with information (R2 = 0.064, P = 0.049).
CONCLUSION
Our long-term results of oncoplastic surgery achieved a high level of patient satisfaction with good cosmetic results. The medical panel and BCCT.core results correlated well with the PROs of the patients using valid, reliable, and procedure-specific measures.

Keyword

Breast; Carcinoma; Quality of life; Superficial back muscles; Surgical flap

MeSH Terms

Breast*
Female
Follow-Up Studies
Humans
Mammaplasty
Patient Satisfaction
Pilot Projects*
Quality of Life
Superficial Back Muscles*
Surgical Flaps

Figure

• 

  Fig. 1 Cosmetic results were analyzed (excellent, good, fair, and poor) by the BCCT.core program using photographs of 64 patients who underwent quadrantectomy with immediate latissimus dorsi flap reconstruction. (A) Excellent outcome, 40-year-old female, 2.2-cm tumor in the right breast upper outer quadrant, 96.2-month follow-up. (B) Good outcome, 61 year-old female, 3-cm tumor in the right breast upper outer quadrant, 142.7-month follow-up. (C) Fair outcome, 46 year-old female, 2.4-cm tumor in the right breast upper outer quadrant, 146.9-month follow-up. (D) Poor outcome, 56-year-old female, 2.1-cm tumor in the right breast upper outer quadrant, 166.5-month follow-up.

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