22 Chapter 2 RESULTS Patient selection Between January 2017 and December 2020, a total of 75 patients underwent OPS. Five patients were lost to follow-up and the remaining 70 patients were invited to participate in the BREAST-Q, self-assessment of cosmetic outcomes and panel evaluation of cosmetic outcomes. The BREAST-Q was completed by 52 patients (response rate 74.3%), self-assessment of cosmetic outcomes by 50 patients (response rate 71.4%) and panel evaluation was performed in 40 patients (57.1%). Study population The total study population consisted of 75 women with a median age of 61 years (IQR: 52-67 years) and a median BMI of 27 kg/m2 (IQR: 24.0-30.1 kg/m2). Volume displacement techniques were used in 74.7% of the patients, involving the Wise pattern (n=54, 96.4%) and the Grisotti technique (n=2, 3.6%). Volume replacement techniques were used in 25.3% of patients, involving the TDAP-flap (n=18, 94.7%) and a bilobed swing (n=1, 5.3%). Follow-up time varied from one to four years. Baseline characteristics were compared between patients who underwent OPS with volume replacement versus volume displacement. A significant difference (P<0.001) between the groups was found in the tumor location, with 17 out of 19 tumors (90%) located in the cranio-lateral quadrant in the volume replacement group while the tumors were more equally distributed in the volume displacement group. Furthermore, 20 patients (35.7%) in the volume displacement group versus only one patient (5.3%) in the volume replacement group underwent a contralateral symmetrization (P<0.01). In all patients, tumor- and surgical characteristics are depicted in Table 1. Postoperative complications Overall, an 18.7% clinically relevant complication rate was found, of which 14.7% had a CD score of 2, and 4% had a CD score of 3. Hematoma and wound dehiscence were reported in one patient (1.3%). Necrosis occurred in two patients (2.7%). An SSI was found in ten patients (13.3%) and led to a CD score of 3 in three patients (4%). No other complications led to a CD score of 3. The presence of seroma never resulted in a CD score of 2 or more. There was no significant difference in complications between the volume replacement and volume displacement groups. Re-excision rates after OPS were similar in both groups: 5.4% in the volume displacement group and 5.3% in the volume replacement group.
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