Patient-reported aesthetic outcomes in oncoplastic breast surgery compared with conventional breast-conserving surgery: a systematic review and meta-analysis
DOI:
https://doi.org/10.29289/259453942024V34S1012Keywords:
breast neoplasms, breast-conserving surgery, breast reconstruction, patient satisfactionAbstract
Objective: We aimed to compare the aesthetic and surgical satisfaction of oncoplastic breast surgery (OBS) to conventional breast-conserving surgery (CBCS). Methodology: This meta-analysis (PROSPERO: CRD42024521223) followed
PRISMA and PICO guidelines. PubMed, Embase, Scopus, Web of Science, and Cochrane databases were searched for
randomized trials and non-randomized studies comparing OBS to CBCS for female breast cancer patients and reporting
outcomes of patient-reported aesthetic results, overall satisfaction, complications, and re-excision. A random-effects
model was performed in the R software. Heterogeneity was assessed using I² statistics. Continuous and dichotomous
data were presented as standardized mean difference (SMD) and odds ratio (OR), respectively. Confidence interval (CI)
was defined at 95%. Results: A total of 36 non-randomized studies were included, along with 9,453 patients, with 3,578
undergoing OBS. OBS yielded better patient-reported aesthetic outcomes compared with CBCS, notably in satisfaction
with breast reconstruction (SMD 0.68; 95%CI 0.126–1.227; p=0.016; I²=89%) and psychosocial well-being (SMD 0.23; 95%CI
0.003–0.459; p=0.047; I²=49%). Physical and sexual well-being showed no significant difference. Overall satisfaction favored OBS (OR 3.08; 95%CI 1.58–6.01; p<0.001; I²=82%), despite higher postoperative complications (OR 1.27; 95%CI 1.003–
1.589; p=0.047; I²=9%). There was no significant difference in infections, seromas, and hematomas; however, OBS showed
a higher risk of skin/nipple-areola complex necrosis (OR 2.56; 95%CI 1.28–5.11; p=0.008; I²=0%). Regarding the need for a
second surgery, OBS had fewer re-excisions (OR 0.46; 95%CI 0.34–0.62; p<0.0001; I²=45%). Conclusion: OBS shows better aesthetic and satisfaction outcomes than CBCS, with reduced re-excisions. Nonetheless, postoperative complications
require careful evaluation.
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Copyright (c) 2026 Maria Clara Ramos Miranda, Charles Karel Martins Santos, Gabriel Alves Barbosa, Melissa Silva Mariano, Giovanna Martins Milhomem, Asafe Ribeiro Dias da Silva, Itamar Fernandes Souza Junior, Otaviano Ottoni da Silva Netto
This work is licensed under a Creative Commons Attribution 4.0 International License.
