Abstract
BackgroundCosmetic result in breast cancer surgery is gaining increased interest. Currently, some 30–40% of the patients treated with breast conserving surgery (BCS) are dissatisfied with their final cosmetic result. In order to prevent disturbing breast deformity oncoplastic surgical techniques have been introduced. The extent of different levels of oncoplastic surgery incorporated in breast conserving surgery and its value with regard to cosmetic outcome, patient satisfaction and quality of life remains to be defined. The aim of this prospective cohort study is to investigate quality of life and satisfaction with cosmetic result in patients with breast cancer, undergoing standard lumpectomy versus level I or II oncoplastic breast conserving surgery.MethodsFemale breast cancer patients scheduled for BCS, from 18 years of age, referred to our outpatient clinic from July 2015 are asked to participate in this study. General, oncologic and treatment information will be collected. Patient satisfaction will be scored preceding surgery, and at 1 month and 1 year follow up. Photographs of the breast will be used to score cosmetic result both by the patient, an independent expert panel and BCCT.Core software. Quality of life will be measured by using the BREAST-Q BCT, EORTC-QLQ and EQ-5D-5 L questionnaires.DiscussionThe purpose of this prospective study is to determine the clinical value of different levels of oncoplastic techniques in breast conserving surgery, with regard to quality of life and cosmetic result. Analysis will be carried out by objective measurements of the final cosmetic result in comparison with standard breast conserving surgery. The results of this study will be used to development of a clinical decision model to guide the use oncoplastic surgery in future BCS.Trial registrationCentral Commission of Human Research (CCMO), The Netherlands: NL54888.015.15.Medical Ethical Commission (METC), Maxima Medical Centre, Veldhoven, The Netherlands: 15.107.Dutch Trial Register: NTR5665, retrospectively registered, 02-25-2016.
Highlights
Cosmetic result in breast cancer surgery is gaining increased interest
In the first Dutch guideline of Oncoplastic surgery (OPS) an urgent need for studies comparing all objective and subjective scoring systems prospectively in well-designed study protocols is recommended [27]. The aim of this prospective cohort study is to assess the additional value of different levels of breast conserving surgery (BCS) in breast cancer patients with, with regard to quality of life and objective cosmetic outcome, in comparison with conventional lumpectomy combined simple closure of the cavity
The COSMAM Trial is a first prospective cohort study that aims to define the role of different levels of additional OPS in BCS for breast cancer patient
Summary
Some 30–40% of the patients treated with breast conserving surgery (BCS) are dissatisfied with their final cosmetic result. The extent of different levels of oncoplastic surgery incorporated in breast conserving surgery and its value with regard to cosmetic outcome, patient satisfaction and quality of life remains to be defined. The aim of this prospective cohort study is to investigate quality of life and satisfaction with cosmetic result in patients with breast cancer, undergoing standard lumpectomy versus level I or II oncoplastic breast conserving surgery. More thorough studies on QoL (psychosocial, physical and sexual well-being) originate only form the last 2 decades This growing awareness for preservation of body image, cosmetic result and QoL is attenuated by the increasing prevalence of patients who survive breast cancer [7]
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