Perspectives of Cosmesis following Breast Conservation for Multifocal and Multicentric Breast Cancers.

Mona P Tan,Nadya Y Sitoh,Yih-Yiow Sitoh

doi:10.1155/2015/126793

Mona P Tan, Nadya Y Sitoh + Show 1 more

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https://doi.org/10.1155/2015/126793

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Abstract

Background. Contemporary data suggest that breast conservation treatment (BCT) for multifocal and multicentric breast cancer (MFMCBC) may be appropriate with noninferior local control rates. However, there is a paucity of data to evaluate patient's satisfaction with cosmetic outcomes after BCT for MFMCBC. This study was performed to bridge this information gap. Methods. All patients treated at the authors' healthcare facility were included in the study. Patients with MFMCBC who were assessed to be eligible for BCT underwent tumour resection using standard surgical techniques with direct parenchymal closure through a single incision. After at least three years of follow-up, they were invited to participate in a survey regarding their cosmetic outcomes. Results. Of a total of 160 patients, 40 had MFMCBC, of whom 34 (85%) underwent successful BCT. Five-year cancer-specific survival and disease-free survival were 95.7%. Twenty of the 34 patients responded to the survey. No patient rated her cosmetic outcome as “poor.” Analysis indicated low agreement between patients' self-assessment and clinician-directed evaluation of aesthetic results. Conclusion. BCT for MFMCBC is feasible with acceptable survival and cosmetic outcomes. However, there appears to be a disparity between patient and clinician-directed evaluation of cosmetic results which warrant further research.

Highlights

Multifocal and multicentric breast cancers (MFMCBC) pose a formidable challenge to breast conservation treatment (BCT)
Studies of multifocal and multicentric breast cancer (MFMCBC) showed poorer local control with BCT than mastectomy [1, 2], which led to multiple ipsilateral cancers being viewed as a contraindication to BCT
Eligibility for BCT was made based on the attending surgeon’s assessment of the clinical indicators. For those considered to have doubtful or borderline eligibility, a recommendation was made for a “trial of BCT,” with the understanding that a mastectomy would be performed if the attempt at BCT resulted in loss of tissue that could not be repaired using volume displacement techniques without mammoplasty or contralateral symmetrisation

Summary

Introduction

Multifocal and multicentric breast cancers (MFMCBC) pose a formidable challenge to breast conservation treatment (BCT). There is little information in contemporary medical literature on cosmetic outcomes and patient satisfaction following BCT for MFMCBC. Contemporary data suggest that breast conservation treatment (BCT) for multifocal and multicentric breast cancer (MFMCBC) may be appropriate with noninferior local control rates. There is a paucity of data to evaluate patient’s satisfaction with cosmetic outcomes after BCT for MFMCBC. Twenty of the 34 patients responded to the survey No patient rated her cosmetic outcome as “poor.” Analysis indicated low agreement between patients’ self-assessment and clinician-directed evaluation of aesthetic results. There appears to be a disparity between patient and clinician-directed evaluation of cosmetic results which warrant further research

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