A comparative study on the cosmetic outcomes of ultrasound-guided versus palpation-guided conservative breast surgery in patients with early palpable breast cancer

In conservative breast surgery, a larger volume of resected breast tissue is associated with a poorer cosmetic outcomes. Therefore, the introduction of ultrasonography in the excision of palpable breast cancer aims to minimize the excision of healthy tissue ensuring oncologically safe excision, and hence, a better cosmetic outcome compared with palpation-guided surgery (PGS). To compare ultrasound-guided surgery (UGS) for palpable breast cancer with PGS in terms of safety margin, re-excision rate, and cosmetic outcome. This is a prospective, randomized, controlled study conducted on 79 female patients with early palpable breast cancer. Patients were randomized to undergo either UGS or PGS. The mean distance between the tumor and the resection margin, re-excision rate, operative time, cosmetic outcome, and patient satisfaction were assessed. Data management and statistical analysis were done using SPSS, version 28. Quantitative data were assessed for normality using the Shapiro–Wilk test and direct data visualization methods. According to normality, quantitative data were summarized as means and SDs. Categorical data were summarized as numbers and percentages. Quantitative data were compared between the studied groups using independent t test. Categorical data were compared using the χ 2 test. Multivariate logistic regression analysis was done to predict good to excellent patient satisfaction. All statistical tests were two-sided. P values less than 0.05 were considered significant. The UGS group showed significantly higher excellent panel evaluation (48.7 vs. 22.5%, P=0.028) and patient satisfaction (61.5 vs. 30%). The UGS group demonstrated significantly longer operative time but significantly lower re-resection rate and distance from tumor to resection margin (0.62±0.16 vs. 1.72±0.35 cm, P<0.001). The predictors of the outcomes were tumor T stage (T2 stages associated with less satisfaction), tumor to resection margin distance (the more distance the less satisfaction), and ultrasound use. The UGS proves to be superior to PGS as it significantly decreases re-excision rates and improves overall cosmetic outcome and patient satisfaction.