Background: With the development of new surgical techniques in breast cancer, such as oncoplastic breast\nsurgery, increased knowledge of risk factors for poor satisfaction with conventional breast-conserving surgery (BCS)\nis needed in order to determine which patients to offer these techniques to. The aim of this study was to\ninvestigate patient satisfaction regarding aesthetic result and skin sensitivity in relation to patient, tumour, and\ntreatment factors, in a consecutive sample of patients undergoing conventional BCS.\nMethods: Women eligible for BCS were recruited between February 1, 2008 and January 31, 2012 in a prospective\nsetup. In all, 297 women completed a study-specific questionnaire 1 year after conventional BCS and radiotherapy.\nPotential risk factors for poor satisfaction were investigated using logistic regression analysis.\nResults: The great majority of the women, 84%, were satisfied or very satisfied with the overall aesthetic result. The\nrate of satisfaction regarding symmetry between the breasts was 68% and for skin sensitivity in the operated breast\nit was 67%. Excision of more than 20% of the preoperative breast volume was associated with poor satisfaction\nregarding overall aesthetic outcome, as was axillary clearance. A high BMI (ââ?°Â¥30 kg/m2) seemed to affect satisfaction\nwith symmetry negatively. Factors associated with less satisfied patients regarding skin sensitivity in the operated\nbreast were an excision of ââ?°Â¥20% of preoperative breast volume, a BMI of 25ââ?¬â??30 kg/m2, axillary clearance, and\nradiotherapy. Re-excision and postoperative infection were associated with lower rates of satisfaction regarding\nboth overall aesthetic outcome and symmetry, as well as with skin sensitivity.\nConclusions: Several factors affect patient satisfaction after BCS. A major determinant of poor satisfaction in this\nstudy was a large excision of breast volume. If the percentage of breast volume excised is estimated to exceed\n20%, other techniques, such as oncoplastic breast surgery, with or without contralateral surgery, or mastectomy\nwith reconstruction, may be considered.
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