Comparison of Outcomes of Standard and Oncoplastic Breast-Conserving Surgery

Abstract

PurposeThe aim of this study is to determine and to compare the oncological outcomes of bilateral reduction mammoplasty to standard breast-conserving surgery for breast cancer.MethodsOne hundred sixty-two patients who received a quadrantectomy because of breast cancer (group 1) and 106 breast cancer patients with macromastia who underwent breast-conserving surgery via bilateral reduction mammoplasty (group 2) between 2003 and 2010 were enrolled in this study.ResultsThe mean follow-up time was 37 months for group 1 and 33 months for group 2. Surgical margins were wider than 2 mm in 82.7% and 10 mm in 76.5% of the patients in group 1. Eleven percent of patients had positive surgical margins in this group. When compared to group 2, the rates were 89%, 84%, and 8.4%, respectively. Three patients (1.8%) in group 1 and one patient (0.9%) in group 2 had local recurrence of the disease and received a mastectomy. No statistical significances were noted for either local recurrence or overall survival between the two groups.ConclusionBilateral reduction mammoplasty has some advantages as compared to the standard conventional breast-conserving surgery techniques without having any unfavorable effects on surgical margin confidence, local recurrence, and survival rates.

How to compare the oncological safety of oncoplastic breast conservation surgery – To wide local excision or mastectomy?

“…15 comparative studies have been published which report on results following OBCS (Table 3) [8,16e21,24,25,28e33]. Of those, 9 papers reported various aspects of oncological outcomes [8,16e21,24,30], but recurrence rates and survival e the ultimate measures of oncological safety e were detailed in three comparative studies only [8,21,30]. OBCS was compared to standard breast conservation techniques (WLE or quandrantectomy) in almost all studies (Table 3.).…”

“…The current evidence for the oncological safety of OBCS is largely based on single-institution uncontrolled retrospective studies along with a few comparative studies where OBCS outcomes are compared to simple WLE or quadrantectomy [2,6e23]. The majority of studies showed similar pathological characteristics in terms of size, grade, subtype, hormone receptor expression and axillary node metastasis [17,18,21,24,25], although some demonstrated that larger tumour size, presence of invasive cancer and axillary nodal metastasis were more common following OBCS [8,19,20]. In these analyses OBCS was compared with WLE exclusively, but a comparison to mastectomy may have been appropriate, too, since more advanced pathology was demonstrated after OBCS.…”

The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer

“…The other breast may be included in surgical procedures performed on patients with ptosis and macromastia to achieve symmetry. In addition to the benefits of dualsided reduction mammoplasty (oncoplastic reduction), a significant number of macromastia complaints are corrected as well [10]. OBCS often achieves a better esthetic result, as it preserves the natural boundaries of the breast and protects the skin [8,11].…”

Combined TRAM flap with latissimus dorsi myocutaneous flap for reconstruction of a large breast post-radiation induced necrosis

“…As in the current case, the radiation-induced deformities and scarring can be difficult to manage, usually requiring secondary reconstruction [5, 6]. …”