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

Abstract

Striking similarities found between OBCS and mastectomy patients' histopathological results are in sharp contrast with previously published data. This study suggests that oncological outcomes following OBCS should be compared to mastectomy besides WLE.

Imaging Results Following Oncoplastic and Standard Breast Conserving Surgery

“…This study showed that, compared to WLE, OBCS was applied to patients with more advanced malignant disease, which is consistent with our previously published results [2]. More ultrasound scans and biopsies were necessary after OBCS than after simple WLE.…”

“…The decision on indication and technique of OBCS was taken by either an oncoplastic breast surgeon alone, or a breast and a plastic surgeon together [2,12]. Patients at risk for developing significant postoperative breast deformity with standard WLE techniques were considered for OBCS.…”

“…Arguably, OBCS may not be directly comparable to standard surgical techniques. However, numerous studies have already been published to benchmark emerging evidence of this relatively new technique compared to well-established standard breast surgery [2,12]. We, therefore, performed a retrospective analysis of postoperative imaging and biopsies, comparing the numbers, indications and outcomes of mammograms, breast ultrasound and magnetic resonance imaging (MRI) scans, and breast biopsies taken in the first 2 years after OBCS and wide local excision (WLE).…”

“…Breast conservation surgery is offered to women with relatively large or poorly located cancers and involves specialized plastic surgical techniques in combination with oncological surgery, commonly referred as oncoplastic breast-conserving surgery (OBCS) [2]. …”

Coming of age of oncoplastic breast surgery

“…Nonetheless, unresolved controversies remain for oncoplastic breast conservation, including identification of a positive resection margin following glandular mobilization, accurate targeting of the tumour bed for a radiotherapy boost, the upper size limit for safe breast conservation, and sequencing of radiotherapy with two‐stage flap‐based partial breast reconstruction.…”