Measurement and Optimizing Cosmetic Outcomes for Breast Excisions/Factors Influencing Aesthetic Outcomes of Breast Conservation Surgery

A favorable aesthetic outcome is meant to be the second most important aim after oncological safety in breast conservation surgery. In times of systematic breast cancer screening, advanced diagnostic techniques, and the widespread use of neoadjuvant systemic therapy with the result of reduced average tumor sizes, breast conservation is nowadays the standard of care in breast cancer surgery and fits to the preferences of most breast cancer patients. There are several described factors influencing aesthetic outcomes which may in part be addressed by the breast surgeon before planning a surgical procedure in order to maintain an optimal aesthetic result. Unfortunately, there is nearly no evidence of how to systematically improve aesthetic outcomes in these cases with assumed negatively influencing factors. This chapter will present and discuss the described factors influencing aesthetic outcomes on the one hand and will hypothesize and present existing evidence on how to optimize outcomes on the other hand.