The cosmetic outcome in early breast cancer treated with breast conservation

Aims: To measure the cosmetic outcome of breast-conserving surgery and identify the factors which influence cosmesis. Methods: A total of 254 patients with primary breast cancer treated by wide local excision, with or without radiotherapy, were subjectively assessed for cosmesis by a six-member panel using photographic evaluation and objectively by an independent observer using specific measurement. Results: Good to excellent cosmetic results were achieved in 184 (72%) patients on panel subjective assessment and 201 (79%) patients on objective assessment. Good correlation (P<0.001) and agreement were found between the panel's subjective photographic assessment and the objective assessment. The main factors found to affect cosmesis negatively were: medially located tumours; weight of specimen; re-excision procedures, radiotherapy; small breasts and longer scars. Conclusion: These cosmetic results, combined with a low local recurrence rate following wide local excision, validate the operative method used.