123P Cosmetic outcome after vacuum-assisted excision is good and independent of the amount of resected tissue

Abstract

A better cosmetic outcome after vacuum-assisted excision is suggested in previous studies, but it has, to the best of our knowledge, never been formally evaluated nor demonstrated. While, providing more insight in patient reported outcomes is especially important for treatment decision making of this non-malignant disease. Therefore, we aimed to evaluate patient reported cosmetic outcome and the contributing variables after vacuum-assisted excision. In this cross-sectional study, patients who underwent vacuum assisted excision were invited to complete the cosmetic subscale of the Dutch Breast Cancer Treatment Outcome Scale (BCTOS-cs). For each patient, the mean cosmetic outcome was calculated and cosmetic outcome was dichotomized as either good or suboptimal. All clinically relevant variables were independently tested for the impact on cosmetic outcome. Variables that were possibly associated with cosmetic outcome (univariate p<0.2) were included in a multivariable regression analysis. The BCTOS-cs was completed by 46 of 64 (73.4%) contacted patients. Mean cosmetic outcome was 1.5 (good) and was not related to the number of resected cores and weight of the specimen (r=0.248, p=0.093 and r=0.221, p=0.131 respectively). Cosmetic outcome was not significantly different between tumors ≥3cm and <3cm (respectively mean 1.74 ± 0.66 vs. 1.53 ± 0.45, p=0.36). The absence of follow-up complications was the only significant factor associated with a better mean cosmetic outcome score (β= 0.367, SE=0.152, p=0.02) and with the dichotomized cosmetic outcome (OR=13.5, 95% CI 1.13-162.0, p=0.04) in the multiple regression analyses. It was already known that vacuum-assisted excision of benign lesions is safe and effective and now this study confirms that the patient reported cosmetic outcome after vacuum-assisted excision is good and independent of tumor size and resected specimen. The absence of complications was the only factor that contributed to a better cosmetic outcome. All recurrent lesions occurred in tumors < 3cm and no severe complications occurred in lesions > 3cm. Thus, vacuum-assisted excision could also be beneficial in patients with larger (> 3cm) benign breast tumors.