Oncoplastic versus conventional breast-conserving surgery in breast cancer: a pooled analysis of 6941 female patients

Abstract

Background Breast cancer is the most prevalent cancer in women. In the past few years, surgical interventions for breast cancer have experienced massive changes from radical excision to conserving approaches. In this study, we aim to compare the two breast surgery interventions, including conventional breast-conserving surgery (CBCS) versus oncoplastic breast-conserving surgery (OPBCS). Methods We searched on PubMed, Web of Science (WOS), Scopus, Embase, and Cochrane till 2 October 2021. All relevant randomized controlled trials (RCTs) and observational studies were included. The data were extracted and pooled using Review Manager software (RevMan 5.4). Results The pooled meta-analysis of the included studies showed that OPBCS was significantly superior to CBCS in most of the outcomes. Re-excision significantly favoured CBCS (RR = 0.49, 95% CI [0.37, 0.63], P < 0.00001). However, local recurrence (RR = 0.55, 95% CI [0.27, 1.09], P = 0.09), close surgical margins (RR = 0.37, 95% CI [0.14, 1.00], P = 0.05) and end up to the risk of mastectomy (RR = 0.73, 95% CI [0.54, 97], P = 0.06) showed no significant difference between both techniques. Notably, while performing a sensitivity analysis, other outcomes as local recurrence, significantly showed favourable results towards OPBCS. In terms of safety outcomes, there was no significant difference between OPBCS and CBCS. Conclusion We recommend the oncoplastic approach rather than the conventional one in females with breast cancer. Re-excision rates showed better results following OPBCS.

Conservative Treatment of Breast Cancer and Oncoplasty at the Teaching Hospital Mother and Child of Jeanne Ebori Foundation in Libreville (Gabon)

“…Currently, breast conservation in retroareolar tumours is made possible by techniques derived from plastic surgery involving removal of the PAM [4]. Oncoplastic breast surgery is a new trend in conventional breast conserving surgery that merges the concepts of oncology and plastic surgery to achieve satisfactory results both oncologically and aesthetically [10]. It allows the removal of significantly larger tumours because it has become an alternative to mastectomy for tumours larger than 4 cm and for locoregional tumours [5] [9] [10] [15] [16] [17].…”

“…The combination of bulky tumour resection by the breast surgeon and immediate breast reconstruction by the plastic surgeon has many advantages, including safer resection with wider margins and immediate aesthetic results [9]. A pooled meta-analysis of the included studies showed that conservative treatment with oncoplasty was significantly superior to standard conservative treatment in most criteria [10].…”