Abstract P3-18-13: A cross-sectional study to investigate association between oncoplastic techniques and patient satisfaction who received breast-conserving surgery
Authors: Mitsueda Reiko , Gen Anri , Fujiki Yoshitaka , Gondo Naomi , Sato Mutsumi , Kawano Junko , Kuninaka Koichi , Kanemitsu Shuichi , Teraoka Megumi , Matsuyama Yoshito , Baba Shinichi , Nomoto Sugako , Sloan Robert , Rai Yoshiaki , Sagara Yoshiaki , Sagara Yasuaki 
Published: March 2022

Abstract
Background The suture scaffold technique (SST) is one of the oncoplastic techniques used for breast-conserving surgery (BCS), first reported in 2010. There is no report about the cosmetic outcome of SST, so we investigated SST patient satisfaction compared with other techniques. Method We started using the SST in August 2017. The SST requires the construction of scaffolds by using non-absorbable strings in the defect during BCS. The strings are pulled together and tied as close as possible without dimpling the skin from the superior to the inferior direction and medial to the defect's lateral direction. After approval by our institutional ethics committee in September 2020, we started a patient survey using the BREAST-QTM-BCT module (postoperative) version 2.0. We included the patients who received BCS from August 2017 to September 2019, except for cT3, patients who received nipple excision or bilateral breast surgery at our institution. The raw sum scale scores of BREAST-QTM were converted into one score that ranges from 0 (worst) to 100 (best). A score of 4 points is considered to be of minimal importance in breast reconstructive surgery. We utilized a multivariable linear regression model to identify the clinical factors associated with the score. The confounding variables included age, density of the breast, nipple-tumor distance, size of the tumor, location of the tumor, number of lymph nodes dissected, blood loss, and operative duration. Result We identified 437 eligible patients during the study period. Among them, 49 (11.7%) patients received no oncoplastic technique (NOT), 237 (56.8%) patients received mobilization technique of breast tissue (MTB), and 151 (36.2%) patients received SST. SST patients had a higher score than NOT and MTB patients in univariable analysis. In a multivariable model, SST patients had a significantly higher score than NOT (+7.1, 95%CI=0.5-13.0, p=0.03) and an equivalent score to MTB (+1.9, 95%CI=-1.9-5.8, p=0.32) patients. In addition, smaller tumors (+0.13; 95%CI=0.01-0.25) and cases with longer nipple-tumor distance (+1.1; 95%CI=0.24-1.9) showed significantly higher score. Conclusion Among patients who received BCS, the SST patients had higher satisfaction than NOT and equivalent satisfaction to MTB. Additional studies are needed to determine the indications and the limitations of this technique. Table. Multivariate logistic regression analyses for estimating the variables that may affect Rasch score who underwent BCS.
Multivariate logistic regression analyses for estimating the variables that may affect Rasch score.Rasch score95% CIp-valueOncoplastic techniqueNOT (49)0 (Reference)BMT (237)5.1-0.7~11.10.08SST (151)7.10.88-13.40.02NTD (cm)1.10.2-1.90.01Size of the tumor (mm)-0.13-0.25~-0.010.02
Citation Format: Reiko Mitsueda, Anri Gen, Yoshitaka Fujiki, Naomi Gondo, Mutsumi Sato, Junko Kawano, Koichi Kuninaka, Shuichi Kanemitsu, Megumi Teraoka, Yoshito Matsuyama, Shinichi Baba, Sugako Nomoto, Robert Sloan, Yoshiaki Rai, Yoshiaki Sagara, Yasuaki Sagara. A cross-sectional study to investigate association between oncoplastic techniques and patient satisfaction who received breast-conserving surgery [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P3-18-13.