Breast Unit, Department of General Surgery, University Hospital Complex A Coruña, A Coruña, Spain.
Breast J. 2021 Jan;27(1):35-43. doi: 10.1111/tbj.14142. Epub 2020 Dec 26.
To analyze risk factors for the cosmetic sequelae of patients treated with oncoplastic procedures and their impact on patient-reported satisfaction.
Prospective nonrandomized study between 2003 and 2020. Complications and cosmetic sequelae were reported by the surgeon. We employed the Clough classification for oncoplastic procedures (Level 1 and Level 2) and to define the cosmetic sequelae (Type I, Type II and Type III). The assessment of satisfaction and quality of life was performed with the BreastQ questionnaire.
429 level 1 and 326 level 2 oncoplastic operations were included. We recorded 89 cosmetic sequelae: 55 deformities (type II), 29 asymmetries (type I), and 5 type III defects. The incidence of cosmetic sequelae at 10 years for levels 1 and 2 oncoplastic procedures was 11.5% and 20.0%, respectively. The level 2 techniques and the postoperative complications increased the risk of cosmetic sequelae. Patients with cosmetic sequelae did not achieve significant improvements in breast satisfaction.
Cosmetic sequelae affect up to 17% of oncoplastic procedures. Most of them appear during the first 5 years. Cosmetic sequelae and their predisposing factors should be part of the shared decision-making process with patients, as well as part of the training programs for breast surgeons.
分析接受肿瘤整形手术治疗的患者发生美容后遗症的风险因素及其对患者报告满意度的影响。
这是一项 2003 年至 2020 年期间进行的前瞻性非随机研究。由外科医生报告并发症和美容后遗症。我们采用 Clough 肿瘤整形手术分类（1 级和 2 级）和美容后遗症分类（I 型、II 型和 III 型）。使用 BreastQ 问卷评估满意度和生活质量。
共纳入了 429 例 1 级和 326 例 2 级肿瘤整形手术。我们记录了 89 例美容后遗症：55 例畸形（II 型），29 例不对称（I 型）和 5 例 III 型缺陷。10 年时 1 级和 2 级肿瘤整形手术的美容后遗症发生率分别为 11.5%和 20.0%。2 级技术和术后并发症增加了美容后遗症的风险。有美容后遗症的患者在乳房满意度方面没有显著改善。
美容后遗症影响了多达 17%的肿瘤整形手术。大多数美容后遗症出现在术后 5 年内。美容后遗症及其相关的风险因素应作为与患者共同决策过程的一部分，以及乳腺外科医生培训计划的一部分。
