18 Chapter 2 ABSTRACT Introduction: This study aimed to evaluate complication rates, patient satisfaction and cosmetic outcomes after oncoplastic breast-conserving surgery. Furthermore, outcome differences between volume displacement and volume replacement techniques and the effect of postoperative complications on outcomes were evaluated. Methods: This was a prospective single-center study addressing patients who underwent oncoplastic breast-conserving surgery from 2017 to 2020. The BREAST-Q was used to measure patient satisfaction and cosmetic outcomes were assessed by patient self-evaluation and panel evaluation based on medical photographs. Results: A total of 75 patients were included. The overall complication rate was 18.7%, of which 4% required invasive interventions. Median BREAST-Q scores ranged from 56 to 100 and cosmetic outcomes were scored good to excellent in 60-86%. No differences in complications were observed between volume replacement and volume displacement techniques. Following volume displacement techniques, patients reported higher BREAST-Q scores for the domain ‘physical well-being of the chest’ and lower cosmetic outcomes scores for ‘mammary symmetry’. Patients with complications scored significantly lower on several domains of the BREAST-Q and in various cosmetic outcome categories. Conclusion: In this cohort, an overall complication rate of 18.7% was observed. Patients were generally satisfied and most cosmetic outcomes were good to excellent. Volume displacement or replacement techniques were performed for different indications and generally showed comparable results. Expected differences in physical discomfort and symmetry between both techniques were observed. In addition, the occurrence of complications resulted in lower patient satisfaction and cosmetic outcomes. These findings emphasize the importance of thorough preoperative counselling.
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