Racial Disparities in Oncoplastic Reduction Mammoplasty and Mastopexy Outcomes.

Abstract

Black race is associated with worse outcomes following implant and autologous breast reconstruction. Although oncoplastic surgery is increasingly used to optimize aesthetic and oncologic outcomes, it remains unclear whether similar racial disparities exist in this setting. This study evaluates the impact of race on surgical and patient-reported outcomes following oncoplastic breast surgery. We conducted a retrospective review of patients who underwent oncoplastic procedures using reduction mammoplasty or mastopexy techniques between January 2017 and December 2024. Primary outcomes included postoperative complications. Secondary outcomes included patient-reported outcomes measured by the BREAST-Q. Demographic and clinical variables were compared between Black and White patients. Multivariable logistic regression was used to identify factors independently associated with complications. Among 518 patients, 18.5% identified as Black and 81.5% as White. Black patients had a higher burden of preoperative risk factors, including elevated BMI, higher ASA class, diabetes, hypertension, advanced cancer stage, and neoadjuvant chemotherapy. However, overall complication rates did not differ significantly between groups. Elevated BMI was independently associated with increased complication risk, whereas race showed no significant association. BREAST-Q scores were similar between cohorts at all time points except at 1 year; Black patients reported significantly lower scores (p=0.046). Oncoplastic surgery in Black patients is associated with complication rates and patient-reported outcomes comparable to those observed in White patients. These findings suggest that oncoplastic surgery may be a viable treatment option for Black patients. However, further prospective, multi-center studies with larger, racially diverse cohorts and longer follow-up are needed to validate these results.