1. Oncoplastic Surgery: Does Patient and Medical Specialty Influences the Evaluation of Cosmetic Results?
- Author
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de Oliveira-Junior I, Brandini da Silva FC, Nazima F, Ribeiro JC Jr, Castellani L, Zucca-Matthes G, Maciel MDS, Biller G, José da Silva J, Sarri AJ, and Aloísio da Costa Vieira R
- Subjects
- Adult, Cross-Sectional Studies, Female, Humans, Mastectomy, Segmental methods, Middle Aged, Prospective Studies, Quality of Life, Surveys and Questionnaires, Treatment Outcome, Breast Neoplasms surgery, Cosmetic Techniques psychology, Esthetics, Mastectomy, Segmental psychology, Patient Satisfaction statistics & numerical data
- Abstract
Background: Oncoplastic surgery (OS) has added plastic surgery concepts and techniques to the breast cancer surgery. However, reports of the impact of OS on cosmesis after breast-conserving surgery (BCS) are limited in the literature., Patients and Methods: This cross-sectional prospective study included patients who underwent BCS. The patients self-evaluated the cosmetic outcome of the breasts and had them photographed. The photos were evaluated by BCCT.core software and by 6 breast surgeons (mastologists and plastic surgeons) using the Harvard, Garbay, and Fitoussi scales. Kappa and weighted kappa tests were used to analyze agreement for categorical variables; for continuous variables, the interclass correlation index and the chi-square test to analyze the association between the OS and the symmetrization., Results: A total of 300 patients were evaluated: 228 (76.0%) underwent traditional BCS and 72 (24.0%) underwent OS, and of these, 37 (51.4%) underwent contralateral symmetrization surgery. In the evaluation of the cosmetic result, the correlation between patients and observers (BCCT.core and surgeons) was weak; between the 2 groups of surgeons, the correlation was moderate (Fitoussi scale) and excellent (Garbay scale). Plastic surgeons are more critical for evaluating cosmetic results; they considered it good or excellent in 30.0% whereas patients, mastologists, and BCCT.core results considered it so in 78.8%, 34.0%, and 30.0%, respectively. In terms of cosmesis, OS and symmetrization did not influence the results in this study with long follow-up., Conclusion: Patients' self-evaluation reported better cosmesis than surgeons' analyses. Plastic surgeons were the most critical. OS and symmetrization did not influence the results., (Copyright © 2020 Elsevier Inc. All rights reserved.)
- Published
- 2021
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