The cosmetic outcome in early breast cancer treated with breast conservation

Aims: To measure the cosmetic outcome of breast-conserving surgery and iden tify 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 f or cosmesis by a six-member panel using photographic evaluation and objecti vely by an independent observer using specific measurement. Results: Good to excellent cosmetic results were achieved in 184 (72%) pati ents on panel subjective assessment and 201 (79%) patients on objective ass essment. Good correlation (P<0.001) and agreement were found between the pa nel's subjective photographic assessment and the objective assessment. The main factors found to affect cosmesis negatively were: medially located tum ours; weight of specimen; re-excision procedures, radiotherapy; small breas ts and longer scars. Conclusion: These cosmetic results, combined with a low local recurrence ra te following wide local excision, validate the operative method used.