Tumor-to-Breast Volume Ratio and Outcomes After Oncoplastic Breast Conserving Surgery.

IF 1.6 4区医学 Q3 SURGERY Annals of Plastic Surgery Pub Date : 2025-04-01 DOI:10.1097/SAP.0000000000004288

Casey Zhang, Alberto Vera, Kelly Murphy, Michael Calcaterra, Vanessa Mroueh, Hamid Alhmari, Carolyn De La Cruz, Michael L Gimbel, Vu T Nguyen, John Austin Vargo, Priscilla F McAuliffe, Brodie A Parent

{"title":"Tumor-to-Breast Volume Ratio and Outcomes After Oncoplastic Breast Conserving Surgery.","authors":"Casey Zhang, Alberto Vera, Kelly Murphy, Michael Calcaterra, Vanessa Mroueh, Hamid Alhmari, Carolyn De La Cruz, Michael L Gimbel, Vu T Nguyen, John Austin Vargo, Priscilla F McAuliffe, Brodie A Parent","doi":"10.1097/SAP.0000000000004288","DOIUrl":null,"url":null,"abstract":"Introduction: Oncoplastic breast conserving surgery (OBCS) can offer oncologically safe and cosmetically satisfying results for patients with breast cancer. However, the relative oncologic safety of high tumor-volume oncoplastic resections is largely unknown. This study investigated the association between tumor-to-breast volume ratio, recurrence, and surgical complications in OBCS. The relationship between tumor-to-breast ratio and quality of life was also assessed.Methods: A retrospective review was performed for all women who underwent OBCS for breast cancer between 2010 and 2023 at a university-based tertiary referral center. The BREAST-Q questionnaire was utilized to assess quality of life outcomes. Tumor-to-breast ratio was calculated by dividing lumpectomy specimen volume by total breast volume. Surgical complications, reexcision, local recurrence, and revision procedures were noted. Multivariate logistic regression was performed to assess the association of tumor-to-breast ratio with outcomes.Results: This study included 192 patients, of which 65 (34%) completed the BREAST-Q. Median tumor-to-breast volume ratio was 7.3% (IQR, 3.6%-12.5%). Quartiles of tumor-to-breast ratio were not associated with local cancer recurrence rate (P = 0.50), reexcision (P = 0.29), wound-related complications (P = 0.45), complications requiring reoperation (P = 0.34), and elective revision of reconstruction (P = 0.67). BREAST-Q scores for Psychosocial Well-being, Physical Well-being, and Overall Satisfaction were similar across tumor-to-breast ratio. Cancer worry was significantly higher in larger tumor-breast ratio quartiles (P = 0.03).Conclusions: These data suggest that OBCS is a reasonable approach for patients with higher tumor-to-breast ratio. Complications and quality of life metrics did not appear to vary significantly with increasing tumor size, except for \"cancer worry,\" which was higher among patients with larger tumor-breast ratio patients.","PeriodicalId":8060,"journal":{"name":"Annals of Plastic Surgery","volume":"94 4S Suppl 2","pages":"S297-S304"},"PeriodicalIF":1.6000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annals of Plastic Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/SAP.0000000000004288","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"SURGERY","Score":null,"Total":0}

引用次数: 0

Abstract

Introduction: Oncoplastic breast conserving surgery (OBCS) can offer oncologically safe and cosmetically satisfying results for patients with breast cancer. However, the relative oncologic safety of high tumor-volume oncoplastic resections is largely unknown. This study investigated the association between tumor-to-breast volume ratio, recurrence, and surgical complications in OBCS. The relationship between tumor-to-breast ratio and quality of life was also assessed.

Methods: A retrospective review was performed for all women who underwent OBCS for breast cancer between 2010 and 2023 at a university-based tertiary referral center. The BREAST-Q questionnaire was utilized to assess quality of life outcomes. Tumor-to-breast ratio was calculated by dividing lumpectomy specimen volume by total breast volume. Surgical complications, reexcision, local recurrence, and revision procedures were noted. Multivariate logistic regression was performed to assess the association of tumor-to-breast ratio with outcomes.

Results: This study included 192 patients, of which 65 (34%) completed the BREAST-Q. Median tumor-to-breast volume ratio was 7.3% (IQR, 3.6%-12.5%). Quartiles of tumor-to-breast ratio were not associated with local cancer recurrence rate (P = 0.50), reexcision (P = 0.29), wound-related complications (P = 0.45), complications requiring reoperation (P = 0.34), and elective revision of reconstruction (P = 0.67). BREAST-Q scores for Psychosocial Well-being, Physical Well-being, and Overall Satisfaction were similar across tumor-to-breast ratio. Cancer worry was significantly higher in larger tumor-breast ratio quartiles (P = 0.03).

Conclusions: These data suggest that OBCS is a reasonable approach for patients with higher tumor-to-breast ratio. Complications and quality of life metrics did not appear to vary significantly with increasing tumor size, except for "cancer worry," which was higher among patients with larger tumor-breast ratio patients.

查看原文

微信好友朋友圈 QQ好友复制链接

本刊更多论文

肿瘤保乳手术后肿瘤与乳房体积比及预后。

肿瘤保乳手术（OBCS）可以为乳腺癌患者提供肿瘤安全且美容满意的结果。然而，高肿瘤体积肿瘤切除术的相对肿瘤学安全性在很大程度上是未知的。本研究探讨了肿瘤与乳腺体积比、复发和手术并发症之间的关系。还评估了肿瘤与乳房比例与生活质量之间的关系。方法：对2010年至2023年间在大学三级转诊中心接受乳腺癌OBCS治疗的所有女性进行回顾性研究。使用BREAST-Q问卷评估生活质量结果。肿瘤与乳房的比值由乳房肿瘤切除标本体积除以乳房总体积计算。记录了手术并发症、再切除、局部复发和翻修手术。采用多变量logistic回归来评估肿瘤与乳房比例与预后的关系。结果：本研究纳入192例患者，其中65例（34%）完成了BREAST-Q检查。中位肿瘤与乳腺体积比为7.3% （IQR, 3.6%-12.5%）。肿瘤与乳房比例的四分位数与局部肿瘤复发率（P = 0.50）、再切除（P = 0.29）、伤口相关并发症（P = 0.45）、需要再手术的并发症（P = 0.34）和选择性重建翻修（P = 0.67）无关。乳房-心理健康、身体健康和总体满意度的BREAST-Q分数在肿瘤-乳房比例中相似。肿瘤与乳房比例越高，对癌症的担忧程度越高（P = 0.03）。结论：这些数据表明，对于肿瘤与乳房比例较高的患者，OBCS是一种合理的方法。并发症和生活质量指标似乎没有随着肿瘤大小的增加而显著变化，除了“癌症担忧”，在肿瘤与乳房比例较大的患者中，这种担忧更高。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文去求助

来源期刊

Annals of Plastic Surgery 医学-外科

CiteScore

2.70

自引率

13.30%

发文量

584

审稿时长

6 months

期刊介绍： The only independent journal devoted to general plastic and reconstructive surgery, Annals of Plastic Surgery serves as a forum for current scientific and clinical advances in the field and a sounding board for ideas and perspectives on its future. The journal publishes peer-reviewed original articles, brief communications, case reports, and notes in all areas of interest to the practicing plastic surgeon. There are also historical and current reviews, descriptions of surgical technique, and lively editorials and letters to the editor.