POSTOPERATIVE APPROACH - METHODS TO BE USED FOR ACCURATE EVALUATION OF PATIENT SATISFACTION AND AESTHETIC RESULTS BEFORE AND AFTER SURGERY

The evolution of breast cancer treatment has been marked by the transition from radical mastectomy to breast-conserving surgery and, more recently, the integration of oncoplastic breast surgery (OPS). OPS combines oncologic and reconstructive techniques to achieve optimal oncologic safety, aesthetic results, and improved quality of life. This chapter highlights the key aspects of OPS, focusing on the methods used to evaluate surgical, aesthetic, oncologic, and quality of life outcomes in the post-operative period. Central to OPS is the ability to preserve breast aesthetics while ensuring effective cancer control, minimising mastectomy rates and reducing complications. Post-operative assessments include surgical outcomes, including scar healing, symmetry, and wound complications; aesthetic out-comes measured by patient self-assessment, photographic documentation, and advanced tools such as the Breast Symmetry Index (BSI) and BCCT.core; and radiological follow-up to monitor for re-currence. In addition, subjective assessments such as patient-reported outcome measures (PROMs) such as BREAST-Q and BCTOS are integral to understanding patient satisfaction and quality of life. Emerging technologies, such as three-dimensional imaging and artificial intelligence, are enhancing the accuracy of cosmetic assessments and surgical planning, although their routine application in clin-ical practice remains limited. The oncological outcomes of OPS show comparable or superior safety to conventional approaches, with lower margin positivity and re-excision rates. Studies confirm its efficacy in achieving long-term survival and low recurrence rates, even in complex cases requiring neoadjuvant therapies. The approach supports individualised treatment by balancing oncologic safety with aesthetic goals, promoting patient-centred care. Quality of life is a cornerstone of OPS, addressing both physical recovery and emotional well-being. Techniques such as autologous reconstruction have been shown to provide superior long-term satisfaction, particularly in irradiated patients. OPS reduces the psychosocial distress associated with delayed reconstructive surgery, emphasising the principle that prevention of poor cosmetic outcomes is better than cure. As the field advances, standardisation of assessment protocols and incorporation of value-based healthcare principles are paramount. This chap-ter highlights the importance of comprehensive, multidisciplinary strategies to achieve high quality outcomes in line with patient goals and modern surgical standards, establishing OPS as a benchmark in breast cancer care.