Background
Breast-conserving surgery (BCS) is a standard treatment for early breast cancer. However, persistent variation in scar placement—either directly over the lesion or at a remote site—is often guided by surgeon or patient preference due to a lack of evidence-based guidelines. Scar location may influence both aesthetic and functional outcomes, yet its impact on patient-reported outcomes remains underexplored. The PROM-S study aims to inform shared decision-making by evaluating how scar placement affects recovery, satisfaction, and quality of life.
Methods
PROM-S is a prospective, non-randomised, single-centre cohort study recruiting patients undergoing BCS for early-stage breast cancer over a 6-month period (Feb–July 2025). The study compares outcomes between patients receiving over-the-lesion versus remote incision placement. Patient-reported outcomes are assessed using the BREAST-Q Breast-Conserving Therapy module at four time points: pre-surgery, 2 weeks, 3 months, and 12 months post-operatively. Clinical data, including demographics, tumour characteristics, treatment details, and surgical outcomes, are collected from electronic health records. The study also explores whether tumour location independently influences PROMs and identifies factors influencing incision choice.
Findings
To date, 58 of a minimum target of 75 participants have been recruited. Preliminary data suggest high feasibility of repeated PROM collection and strong patient engagement. BREAST-Q domains include physical, psychosocial, and sexual wellbeing, satisfaction with breasts, and care experience. Clinical outcomes such as complication rates, re-excision, and treatment changes are also being tracked. Qualitative feedback will provide insight into patient and clinician perspectives on scar placement.
Conclusion
PROM-S will generate novel evidence on the impact of scar placement in BCS, supporting more informed, patient-centred surgical planning. Findings will guide future practice and contribute to the development of tailored information resources for patients and clinicians.