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Predictors of breast asymmetry after breast-conserving operation for breast cancer.

Abstract：

BACKGROUND:Although breast-conserving surgery is the standard of care for early-stage breast cancer, many women report breast asymmetry after this procedure. Risk factors for poor esthetic outcomes are not well understood. STUDY DESIGN:A self-administered survey was sent to patients who underwent lumpectomy (n = 898) at the University of Michigan Medical Center between January 2002 and May 2006 (n = 714, response rate = 79.5%). Breast asymmetry was assessed using items from the Breast Cancer Treatment and Outcomes Survey. Responses were summed to generate a score, and linear regression was used to generate adjusted breast asymmetry scores by patient-related factors (age, body mass index [BMI], tumor size, and tumor position in the breast) and treatment factors (reexcision lumpectomy, radiation therapy, and postoperative seroma). RESULTS:Patient-related risk factors for breast asymmetry included younger age (asymmetry score: 18.7 versus 16.2, p = 0.03), higher BMI (17.1 versus 19.2, p = 0.007), and larger tumors (16.7 versus 19.1, p = 0.01). Resection of superior medial tumors and inferior lateral tumors was also associated with substantially higher asymmetry. Treatment-related risk factors for asymmetry included reexcision lumpectomy (18.1 versus 16.9, p = 0.013), postoperative seroma (19.3 versus 17.2, p = 0.005), and radiation therapy (17.9 versus 15.0, p = 0.008). Increasing breast asymmetry score was associated with a higher odds of desiring breast reconstruction (odds ratio = 1.2, 95% CI, 1.13 to 1.30). CONCLUSIONS:Both patient- and treatment-related factors place women at risk for poor esthetic outcomes after breast-conserving surgery. Oncoplastic and reconstructive options should be considered for those at a higher risk for poor esthetic outcomes at the time of consultation.

journal_name

J Am Coll Surg

journal_title

Journal of the American College of Surgeons

authors

Waljee JF,Hu ES,Newman LA,Alderman AK

doi

10.1016/j.jamcollsurg.2007.07.029

subject

Has Abstract

pub_date

2008-02-01 00:00:00

pages

274-80

issue

2

eissn

1072-7515

issn

1879-1190

pii

S1072-7515(07)01342-7

journal_volume

206

pub_type

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