Determinant of Patient Satisfaction and Outcomes of Local Breast Tissue Flaps in Central Breast-Conserving Surgery: A prospective Cohort Study

Background: Central breast tumors pose unique challenges for breast-conserving surgery (BCS), as excision may compromise breast aesthetics and symmetry. Local tissue flaps are increasingly used for reconstruction, but evidence on outcomes and patient satisfaction in this setting remains limited.Objective: To evaluate surgical outcomes and patient-reported satisfaction following local flap reconstruction after centro-partial BCS, with particular focus on aesthetic results, complication rates, and quality of life.Methods: A prospective cohort study of 69 women with central breast cancer who underwent centro-partial BCS and immediate reconstruction with local tissue flaps was analyzed. Data included demographics, breast measurements, tumor characteristics, flap type and movement, operative details, and postoperative complications. Patient satisfaction was assessed using a validated questionnaire and categorized as poor, fair, good, or excellent. Statistical analysis examined associations between satisfaction and clinical or surgical factors.Results: Overall satisfaction was high: 52.2% of patients rated outcomes as excellent and 30.4% as good. Tumor size (p=0.006) and focality (p=0.038) were significantly associated with satisfaction, while flap type, flap movement, and operative duration showed no significant influence. Complications—including infection (p=0.006), flap necrosis (p<0.001), seroma (p=0.028), and reoperations (p<0.001)—were strongly linked to lower satisfaction.Conclusion: Local tissue flap reconstruction after centro-partial BCS provides favorable aesthetic and satisfaction outcomes. Patient-reported satisfaction is influenced more by tumor factors and postoperative complications than by flap type or surgical technique. Efforts to minimize complications are critical to optimizing patient quality of life.