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Plastic and reconstructive surgery
11 01, 2022;150 (5): 950e-958e.

How Does Oncoplastic Surgery Compare with Standard Partial Mastectomy? A Systematic Review of Patient-Reported Outcomes.

Sydney Char, Joshua A Bloom, Zachary Erlichman, Michael Jonczyk, Abhishek Chatterjee, Lifei Guo
Author Information
  1. Sydney Char: From the University of Kentucky; Tufts Medical Center; Stony Brook University; and Lahey Hospital & Medical Center.
  2. Joshua A Bloom: From the University of Kentucky; Tufts Medical Center; Stony Brook University; and Lahey Hospital & Medical Center.
  3. Zachary Erlichman: From the University of Kentucky; Tufts Medical Center; Stony Brook University; and Lahey Hospital & Medical Center.
  4. Michael Jonczyk: From the University of Kentucky; Tufts Medical Center; Stony Brook University; and Lahey Hospital & Medical Center.
  5. Abhishek Chatterjee: From the University of Kentucky; Tufts Medical Center; Stony Brook University; and Lahey Hospital & Medical Center.
  6. Lifei Guo: From the University of Kentucky; Tufts Medical Center; Stony Brook University; and Lahey Hospital & Medical Center.
PMID: 35994341 DOI: 10.1097/PRS.0000000000009616

Abstract

BACKGROUND: Many breast-conserving surgical options exist for patients with breast cancer. Surgical choices can have lasting effects on a patient's life, so patient satisfaction is important to assess. patient-reported outcome measures provide important tools when evaluating surgical modalities. This systematic review aimed to evaluate how patients describe breast-conserving surgical choices in standard partial mastectomy and oncoplastic surgery options.
METHODS: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses search was performed in PubMed for studies discussing standard partial mastectomy or oncoplastic surgery and measurement of preoperative and postoperative patient-reported outcomes using the BREAST-Q or other validated patient-reported outcome measures. Oncoplastic surgery was categorized as volume displacement or volume replacement. Articles in languages other than English, not involving partial mastectomy or oncoplastic surgery, or not measuring patient-reported outcomes were excluded. Weighted proportions were generated and analyzed with a Welch t test.
RESULTS: Of 390 articles, 43 met inclusion criteria, and 8784 patients were included in a pooled database. Although standard partial mastectomy scored well, oncoplastic surgery performed significantly better than partial mastectomy in all postoperative BREAST-Q categories: satisfaction with breasts (74.3 versus 65.7), psychosocial well-being (81.3 versus 78.0), sexual well-being (61.6 versus 54.9), and satisfaction with outcome (85.4 versus 62.2). Level 2 volume displacement surgery had the most favorable scores.
CONCLUSIONS: Breast-conserving surgical choices that include a variety of oncoplastic surgery and partial mastectomy methods all score well in patient-reported outcome measures, with oncoplastic surgery significantly preferred over partial mastectomy. Oncoplastic surgery should be considered in all cases, and the appropriate breast-conserving surgical choice should depend on the patient's tumor presentation and anatomy.

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MeSH Term

Humans
Female
Mastectomy, Segmental
Mastectomy
Breast Neoplasms
Mammaplasty
Patient Reported Outcome Measures
Systematic Review Journal Article
Article has an altmetric score of 7

Word Cloud

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