Breast Cancer Research and Treatment

, Volume 153, Issue 2, pp 345–351 | Cite as

Long-term objective esthetic outcome after breast-conserving therapy

  • André Hennigs
  • Benjamin Hartmann
  • Geraldine Rauch
  • Michael Golatta
  • Patrik Tabatabai
  • Christoph Domschke
  • Sarah Schott
  • Florian Schütz
  • Christof Sohn
  • Joerg HeilEmail author
Clinical trial


The prediction of unfavorable long-term esthetic outcome (AO) is important for patient consultation. We aimed to analyze variables characterizing the improvement and impairment of AO over time after breast-conserving surgery. A subgroup of a prospective, monocenter cohort study was analyzed to evaluate the results of the BCCT.core software (Breast Cancer Conservative Treatment.cosmetic results) which was used to objectively assess the AO before (n = 356), shortly after (n = 294) and in median 3 years after surgery (n = 356). We analyzed potential influencing factors (such as body mass index, (y)pT-stage, weight of resected specimen, etc.) on the AO using logistic regression analyses (n = 256). Finally, we tried to characterize groups of patients with improving or impaired AO over time (n = 294). Predictors for an unfavorable AO were an axillary lymphadenectomy (OR = 4.05), a tumor in the 12 o’clock position (OR = 2.22), a tumor stage larger or equal to (y)pT2 stage (OR = 2.11), and a surgical specimen weight >75 g (OR = 2.71). Patients with lower specimen weight were more likely to improve in the long-term follow-up (p = 0.018), whereas patients with a higher (y)pT-stage tended to become impaired with time. Although overall AO decreased over time, nearly half of the patients with an unfavorable AO shortly after surgery improved in the long-term follow-up. Predictors of unfavorable AO can be used in patient consultation preoperatively to prepare them for the postsurgical period and/or to recommend surgical alternatives (e.g., more complex oncoplastic techniques). Knowledge of improvement and impairment may help patients and physicians in the postsurgical consultation setting.


Breast cancer Objective aestethic outcome Breast-conserving therapy Bcct.core 



Prof. Joerg Heil received funding from the German Research Foundation (HE 6824/1-1).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

The ethics commission of the University of Heidelberg Medical School approved the study. All patients gave their written consent to participate.

Supplementary material

10549_2015_3540_MOESM1_ESM.docx (14 kb)
Supplementary material 1 (DOCX 13 kb)


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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • André Hennigs
    • 1
  • Benjamin Hartmann
    • 1
  • Geraldine Rauch
    • 1
  • Michael Golatta
    • 1
  • Patrik Tabatabai
    • 1
  • Christoph Domschke
    • 1
  • Sarah Schott
    • 1
  • Florian Schütz
    • 1
  • Christof Sohn
    • 1
  • Joerg Heil
    • 1
    Email author return OK on get
  1. 1.University Breast UnitUniversity Hospital of HeidelbergHeidelbergGermany

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