Evaluation of Surgical Outcomes of Oncoplasty Breast Surgery in Locally Advanced Breast Cancer and Comparison with Conventional Breast Conservation Surgery

Abstract

The purpose of this study was to compare early oncologic outcomes of oncoplastic breast surgery and conventional breast conservation surgery in patients of locally advanced breast cancer. A single-center, prospective, nonrandomized study enrolled select cases of locally advanced breast cancer (TNM T3/T4, N0/1/2) who after neoadjuvant chemotherapy, were considered for breast conservation surgery with oncoplasty techniques. The specimen volume resected, the mean margins and mean closest margin obtained were noted. The re-surgery rates, complication rates, and incidence of locoregional recurrence were also noted. Variables were compared with a retrospective cohort of similar patients who had undergone conventional breast conservation surgery. Fifty-seven patients underwent OBS (group 1) and were compared with 43 cases that had undergone conventional BCS (group 2). Majority of the patients in group 1 (73 %) had cT3 with N0 or N+ and a minority (17 %) were with limited skin involvement (cT4 and N0/N+). Relatively larger sized, post-NACT tumors could undergo OBS(4.4 vs 2.3 cm). Relatively greater proportion of tumors in central and lower quadrants were addressed by oncoplasty than traditional BCS (17/57, 29 % vs 4/43, 9 %, p = 0.04). The mean specimen volume excised in group 1 was more than that in group 2. (187.54 vs 125.19; p = 0.01). The mean of the margins were obtained more in group 1 (1.04 vs 0.69 cm); p < 0.01) as also the mean closest margin (0.86 vs 0.49 cm; p < 0.01). The incidence of close or involved margins was lesser in the OBS group (8 vs 24 %). Overall incidence of complications was similar in both groups (8/57, 14 % vs 4/43, 9 %; p = 0.34 NS). The median follow-up period of group 1 is 18 months (range 06-30 months) while group 2 is 34 months (14-44 months. There was no recurrence in group 1, but there were 5 cases (11 %) in group 2. Oncoplasty breast surgery offers more opportunity for breast conservation and oncologic safety than conventional breast conserving surgery.

Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis

“…Over the years, accredited breast centers in the United States have transitioned away from only PM or M procedures and incorporated reconstructive procedures. However, previous retrospective analyses comparing PM to M showed nationwide inconsistencies between annual breast reconstruction trends [7–14]. Understanding trends in breast surgery is extremely important with regards to prioritizing surgical training requirements for surgical trainees, and identifying the status quo so that improvements or adjustments could be made if these trends were not favored by the present outcomes data.…”

Oncoplastic surgery in conservative surgical treatment of locally advanced breast cancer: a systematic review

“…Six studies included more than 100 subjects [6][7][8][9][10][11] , and the percentage of patients diagnosed with LABC treated with OPS techniques ranged from 4 to 57% among these studies ( Table 1).…”

“…Six studies only included patients diagnosed with LABC, with samples ranging between 42 and 119 patients 7,8,[12][13][14][15] . In these studies, the percentage of use of neoadjuvant CT varied from 70 to 100% (Table 1).…”

“…Among the prospective series, the one with the highest number of patients aimed to compare the oncological outcomes of 100 patients with an initial diagnosis of LABC who underwent CST or OPS after the chemotherapy treatment 8 .…”

Application of a rhomboid flap for the coverage of defects after malignant breast tumor resection: A case report

“…For patients with LABC, oncoplastic breast surgery is frequently required for cosmetic reasons, in addition to wound management, due to the large amount of skin and soft tissue resection in the majority of cases. Only a few studies have investigated the safety of BCS with oncoplastic surgery compared with BCS without oncoplastic surgery in patients with LABC (32,33), so additional research in this area is required.…”