Impact of breast-conserving surgery incisions on aesthetics, satisfaction, and complications: A prospective study.

Abstract

e12603 Background: Breast-conserving (BCS) is favored for its aesthetics benefits and minimal invasiveness. Ensuring tumor safety is essential, but so are post-surgery appearance, satisfaction, and complications. Incision selection for BCS influences both operability of procedures and postoperative results. This study aims to investigate the impact of different incisions on the aesthetic outcome, patient satisfaction, and postoperative complications of BCS. Methods: A prospective single-center cohort study was conducted from July 2020 on breast cancer patients who underwent BCS. The Breast-Q questionnaire and the Aesthetic Items Scale (AIS) were used to assess breast aesthetics and satisfaction outcomes at different times before and after surgery. Complications evaluated include incision dehiscence, subcutaneous hydrops, and nipple-areolar complex (NAC) ischemia, which were recorded once postoperatively and classified according to the Clavien-Dindo classification. Results: A total of 429 patients were enrolled in this study: 247 with a periareolar incision, 30 with a crescentic periareolar incision, 41 with a curvilinear incision, and 111 with a radial incision. Compared to traditional radial incisions, the periareolar and crescent incisions showed significantly better results in psychological well-being, sexual well-being, satisfaction with breasts, and AIS scores at 1-, 3-, and 6-months post-operation. The crescentic incision demonstrated a notable advantage in physical well-being: chest at the 6-month. In contrast, no significant difference was observed between the curvilinear and radial incisions in terms of these outcomes. The overall complication rates for periareolar, crescentic periareolar, curvilinear, and radial incisions were 11.3%, 16.7%, 9.8%, and 7.2%, respectively, indicating no significant differences. Similarly, the rates of NAC ischemia for the periareolar (5.7%) and crescentic (3.3%) incisions did not significantly differ. All complications were graded in categories I to III, and the distribution showed no statistically significant differences among the four groups. Conclusions: Among various incisions, periareolar and crescentic incisions demonstrated superior outcomes in postoperative follow-up, with a comparable incidence of complications to other incisions. These findings may provide valuable surgical decision-making guidance for achieving optimal aesthetic and clinical outcomes in BCS.