Oncoplastic surgery: does patient and medical specialty influences the evaluation of cosmetic results?

Abstract Introduction Oncoplastic surgery (OS) has added plastic surgery concepts and techniques to the breast cancer surgery. However, reports of the impact of OS on cosmesis after breast-conserving surgery (BCS) are limited in the literature. Methods This cross-sectional, prospective study included patients who underwent BCS. The patients self-evaluated the cosmetic outcome of the breasts and had them photographed. The photos were evaluated using BCCT.core software and by six breast surgeons (mastologists and plastic surgeons), using the Harvard, Garbay and Fituosi scales. Kappa and weighted kappa tests were used to analyse agreement for categorical variables; for continuous variables, the interclass correlation index and the chi-square test to analyse the association between the OS and the symmetrisation. Results A total of 300 patients were evaluated: 228 (76,0%) underwent traditional BCS and 72 (24,0%) underwent OS, of these, 37 (51,4%) underwent contralateral symmetrisation surgery. In the evaluation of the cosmetic result, the correlation between patients and observers (BCCT.core and surgeons) was weak between the two groups of surgeons, the correlation was moderate (Fituosi scale) and excellent (Garbay scale). Plastic surgeons are more critical for evaluating cosmetic results, they consider it good or excellent in 30,0%, while patients, mastologists and BCCT.core consider in 78,8%, 34,0% and 30,0%, respectively. In terms of cosmesis, OS and symmetrisation did not influence the results in this study with long follow up. Conclusion Patients evaluate themselves better than surgeons. Plastic surgeons were more critical. OS and symmetrisation did not influence the results.