Annelotte van Bommel

52 Figure 3. Correlation per hospital between the proportion of patients who undergo primary Breast Conserving Surgery (BCS) and the cumulative proportion of patients who have BCS following neo-adjuvant chemotherapy and patients who undergo immediate breast reconstruction fol- lowing mastectomy. DISCUSSION We present BCPP as an esthetic local outcome measure in breast cancer patients. BCPP provides a comprehensive parameter encompassing various treatment strategies to maintain the breast contour in patients treated for breast cancer. While in the Netherlands the rate of BCS remained stable during the study period, the rate of BCPP increased, from 63% in 2011 to 71% in 2015. This increase is the result of increased use of BCS after NAC and mastectomy with IBR. To the best of the authors’ knowledge, no other studies have described BCPP as a composite measure to evaluate local esthetic outcome. Many studies have reported trends of the separate surgical, reconstructive, and medical modalities in patients treated Percentage of patients with BCS with neo-adjuvant therapy or immediate breast reconstruction following mastectomy per hospital Percentage of patients with primary BCS for invasive breast cancer per hospital 30% 35% 40% 45% 50% 55% 60% 65% 70% 50% 45% 40% 35% 30% 25% 20% 15% 10% 5% 0%