Association of immediate symmetrizing oncoplastic surgery with patient-reported outcomes in patients with breast cancer - A retrospective cohort study

Martin Heidinger; Gilles Bilfeld; Nico Föge; Julie M Loesch; Nadia Maggi; Rama Kiblawi; Ruth S Eller; Marie Louise Frevert; Fabienne D Schwab; Christian Kurzeder; Tibor A Zwimpfer; Walter P Weber

doi:10.1016/j.amjsurg.2025.116286

Association of immediate symmetrizing oncoplastic surgery with patient-reported outcomes in patients with breast cancer - A retrospective cohort study

Am J Surg. 2025 May:243:116286. doi: 10.1016/j.amjsurg.2025.116286. Epub 2025 Mar 4.

Authors

Affiliations

¹ Breast Center, University Hospital Basel, Basel, Switzerland; Gynecological Cancer Center, University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland.
² Breast Center, University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland; Institute of Molecular Health Sciences, ETH Zurich, Zurich, Switzerland.
³ Novustat GmbH, Wollerau, Switzerland.
⁴ Breast Center, University Hospital Basel, Basel, Switzerland; Gynecological Cancer Center, University Hospital Basel, Basel, Switzerland.
⁵ Gynecological Cancer Center, University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland; Department of Biomedicine, University of Basel, Basel, Switzerland.
⁶ Breast Center, University Hospital Basel, Basel, Switzerland; University of Basel, Basel, Switzerland. Electronic address: walter.weber@usb.ch.

PMID: 40064063
DOI: 10.1016/j.amjsurg.2025.116286

Abstract

Introduction: Oncoplastic breast surgery (OPS) with immediate symmetrization is commonly performed. However, its impact on patient-reported outcomes (PROs) remains uncertain.

Methods: Patients with stage 0-III breast cancer who underwent OPS (including oncoplastic breast conserving surgery, or nipple- or skin-sparing mastectomy) at a Swiss university hospital between 01/2013-12/2023 who completed a postoperative BREAST-Q questionnaire were identified from a prospectively maintained database. A generalized linear model was used to detect differences in PROs between those who underwent unilateral versus immediate symmetrizing surgery.

Results: Of 441 eligible patients, 333 (75.5 %) underwent unilateral OPS, while 108 (24.5 %) underwent bilateral OPS. Median time to PRO assessment was 35.1 months (Q1-Q3 13.4-49.5). No differences in PROs were identified between patients who underwent unilateral versus bilateral OPS. Short-term surgical morbidity was more common in patients who underwent symmetrizing surgery, which negatively impacted PROs.

Conclusion: The present study did not demonstrate any impact of immediate symmetrization on PROs.

Keywords: Breast cancer; Oncoplastic surgery; Patient-reported outcomes; Quality of life.

MeSH terms

Adult
Aged
Breast Neoplasms* / pathology
Breast Neoplasms* / surgery
Female
Humans
Mammaplasty* / methods
Mastectomy* / methods
Mastectomy, Segmental* / methods
Middle Aged
Patient Reported Outcome Measures*
Retrospective Studies
Time Factors