Evaluation of Factors Impacting Cosmetic Outcome of Breast Conservative Surgery - a Study in Iran

Background: Breast conservative surgery (BCS) followed by radiotherapy is the standard approach inmanagement of stage I-II breast cancer. Several factors can affect cosmetic outcomes. The aim of this study wasto evaluate the cosmetic results of BCS and influencing factors in the Iranian Breast Cancer Research Center.Materials and
Methods: Patients who had undergone BCS were included. Photographs were taken of both breastsof the patients in three aspects and were evaluated by three specialists. The cosmetic scores were calculatedbased on a standard questionnaire. The data were analyzed using univariate and multivariate regression forrelationships between cosmetic scores and clinical data.
Results: A total number of 103 patients were included inthe study. Mean age and BMI of the patients were 46.8±8.9 and 28.1±3.9, respectively. Breast cup sizes C and Daccounted for 74.7% of the study group. The mean cosmetic score obtained from three referees was 5.72+2.06,consisting of 35.9% excellent-good, 35% moderate, and 29.1% unsatisfactory results. Patient BMI, volume of theresected tissue and breast cup size (D) showed significant correlation with the cosmetic score. On multivariateregression analysis, cosmetic score and BMI (p=0.022,) as well as breast cup size (p=0.040), remained significant.
Conclusions: Immediate or delayed symmetrization of the breasts is suggested during breast conservative surgery,meanwhile performing oncoplastic techniques to improve the results significantly. Also it is suggested to discussanticipation of less satisfactory results with patients having higher BMI and large breast cup size.