Comparative Analysis of the Degree of Patient Satisfaction After Breastconserving Surgery With or Without Oncoplastic Surgery: A Systematic Review and Meta-Analysis

Abstract

Objective: A systematic review was carried out on the comparative analysis of the degree of satisfaction of patients undergoing breast-conserving surgery for the treatment of breast cancer, with and without oncoplastic surgery, in addition to performing a meta-analysis to integrate the results of studies carried out with different questionnaires to arrive at a summary measure that could homogenize and categorize this complex comparative analysis arising from such diverse quantitative collection methods. Methods: Systematic review with literature searches in MEDLINE (by PubMed), EMBASE, ClinicalTrials, Scopus, Web of Science, BVS, and OpenGrey. The Joanna Briggs Institute tools were used to evaluate the methodological quality of the studies. Data were summarized through meta-analyses using a random effects model and considered relative risk (RR) measures and their confidence intervals (95%CI). Results: After eligibility assessment, we included 6 studies in the systematic review and in the quantitative analysis, encompassing a total of 1,110 patients. The studies included seemed to have an overall good methodological quality. There was no statistically significant difference in the aesthetic outcome between women who underwent oncoplastic and conservative surgery (RR=0.98; 95%CI 0.91–1.04). Patients undergoing conservative surgery with oncoplastic surgery have more advanced staging, greater tumor size, and resected specimen weight compared to classical surgery. In addition, a higher frequency of breast tumor location is unfavorable to the best aesthetic result (central, medial, or inferior). Conclusion: The degree of patient satisfaction with conservative surgery, with or without oncoplastic surgery, is similar between the groups. The time elapsed from the surgery to the measurement of the outcome, and the tumor conditions seem to have an impact on this result. There is no specific or standardized questionnaire to assess patient satisfaction with conservative surgery, bringing limited and controversial results. Standardization in the quantification of these data in further studies is suggested.