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Evaluating Clinical, Aesthetic, And Patient-reported Outcomes: A Comparative Study Of Reduction Mammoplasty Versus Oncoplastic Breast Reconstruction
SeungJu Jackie Oh, MD, Jennifer Rodriguez, BS, Kevin Hu, BS, Paris D. Butler, MD, MPH, FACS.
Yale University School of Medicine; Division of Plastic Surgery, New Haven, CT, USA.
PURPOSE: Oncoplastic breast reconstruction, combining tumor resection with volume reduction and soft tissue redraping, benefits women undergoing breast conservation surgery by not only alleviating macromastia symptoms but also enhancing symmetry, shape, and cosmesis. This study aimed to compare oncoplastic breast reconstruction with standard bilateral breast reduction (BBR) in clinical safety profile, patient-reported outcomes and aesthetic results.
METHODS: A single-surgeon retrospective review was conducted on patients who underwent bilateral oncoplastic or reduction mammaplasty from April 2022 to October 2024. Demographics, clinical data, Quality of Life (QoL), and aesthetic outcomes were collected via electronic medical records, BREAST-Q surveys, and 1:1 propensity score-matched cases (assessed using a 1-5 Likert scale across six domains). Statistical analyses were performed using chi-square tests, and unpaired and paired t-tests as appropriate.
RESULTS: Among 92 patients, 56 (60.9%) received BBR and 36 (39.1%) oncoplastic reconstruction. Macromastia patients were younger and had greater resection weights (p<0.05). Oncoplastic reconstruction patients had higher BMI and ASA class (p<0.05). Wise pattern incision was utilized in all BBR and 94.4% of oncoplastic cases. Complication rates were comparable between two cohorts. Both cohorts showed significantly higher post-op BREAST-Q scores in psychosocial, sexual, and physical well-being, in addition to satisfaction with breasts. Aesthetic scores slightly favored BBR, though by less than 0.5 Likert scale in all six domains.
CONCLUSION: Oncoplastic reconstruction provides significant QoL improvement with comparable safety profile and aesthetic outcomes, further supporting its role as a favorable reconstructive option when lumpectomy is indicated.
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