Cosmetic outcomes of oncoplastic surgeries in breast cancer patients: an eleven-year experience from two tertiary referral centers.

[PURPOSE] Oncoplastic surgery (OPS) is an essential component of breast cancer treatment, aiming to achieve optimal aesthetic outcomes while ensuring oncological safety. However, evidence comparing the cosmetic outcomes of various OPS techniques remains limited. This study evaluates the aesthetic results of OPS procedures in breast cancer patients.

[METHODS] This observational study included 494 breast cancer patients who underwent different OPS techniques. Six months post-radiotherapy, cosmetic outcomes were assessed using the Harvard scale by an expert committee. Additionally, a plastic surgeon evaluated outcomes using an objective scoring system. Various surgeon-reported aesthetic parameters were analysed.

[RESULTS] Cosmetic outcomes were assessed using two scoring systems. The median cosmetic score for both type I and type II OPS was 8. However, in the first quartile, type II OPS scored one point lower than type I OPS. Based on the Harvard scale, the distribution of "excellent," "good," and "fair" ratings was 58.4%, 38.4%, and 3.2% for type I surgery, and 48.2%, 46.3%, and 5.4% for type II surgery, respectively, with no significant difference (P = 0.124). The round block, lateral perforator flap, bilateral mammoplasty, and racquet techniques demonstrated superior cosmetic outcomes compared to the batwing technique (P < 0.05). A significant association was found between nipple-areolar complex position and OPS technique (P = 0.013).

[CONCLUSION] The surgical algorithm used in this study facilitated acceptable aesthetic outcomes regardless of tumor size and location. Among type II OPS techniques, the round block approach yielded the highest cosmetic ratings, while the batwing technique produced the least favorable results.