Six-year follow-up of patients treated with oncoplastic reduction mammoplasty: A cohort study

Kabir, Syed Adnan; Stallard, Sheila; Weiler-Mithoff, Eva-Maria; Mansell, James; Mallon, Elizabeth; Doughty, Julie; Romics, László

doi:10.1016/j.ijsu.2016.01.001

Cited by 19 publications

(7 citation statements)

References 35 publications

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“…This study has shown that oncoplastic breast conservation is likely to offer better outcomes than mastectomy with or without breast reconstruction for many women and, together with emerging evidence to support the long‐term oncological safety of oncoplastic breast conservation, adds further support to the use of TM as an alternative to mastectomy. Further work is now needed determine whether TM improves patient‐reported outcomes and is cost‐effective compared with mastectomy with and without immediate breast reconstruction before definitive recommendations for best practice can be made.…”

Section: Discussionmentioning

confidence: 70%

Therapeutic mammaplasty is a safe and effective alternative to mastectomy with or without immediate breast reconstruction

Potter

Trickey

Rattay

et al. 2020

British Journal of Surgery

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Background: Therapeutic mammaplasty (TM) may be an alternative to mastectomy, but few well designed studies have evaluated the success of this approach or compared the short-term outcomes of TM with mastectomy with or without immediate breast reconstruction (IBR). Data from the national iBRA-2 and TeaM studies were combined to compare the safety and short-term outcomes of TM and mastectomy with or without IBR. Methods:The subgroup of patients in the TeaM study who underwent TM to avoid mastectomy were identified, and data on demographics, complications, oncology and adjuvant treatment were compared with those of patients undergoing mastectomy with or without IBR in the iBRA-2 study. The primary outcome was the percentage of successful breast-conserving procedures in the TM group. Secondary outcomes included postoperative complications and time to adjuvant therapy.Results: A total of 2916 patients (TM 376; mastectomy 1532; mastectomy and IBR 1008) were included in the analysis. Patients undergoing TM were more likely to be obese and to have undergone bilateral surgery than those having IBR. However, patients undergoing mastectomy with or without IBR were more likely to experience complications than the TM group (TM: 79, 21⋅0 per cent; mastectomy: 570, 37⋅2 per cent; mastectomy and IBR: 359, 35⋅6 per cent; P < 0⋅001). Breast conservation was possible in 87⋅0 per cent of patients who had TM, and TM did not delay adjuvant treatment.Conclusion: TM may allow high-risk patients who would not be candidates for IBR to avoid mastectomy safely. Further work is needed to explore the comparative patient-reported and cosmetic outcomes of the different approaches, and to establish long-term oncological safety. * Members of the iBRA-2 and TeaM Steering Groups, the Breast Reconstruction Research Collaborative, and the Mammary Fold Academic and Research Collaborative are co-authors of this study and are listed in Appendix S1 (supporting information) Earlier versions of the combined analysis were presented to the

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Section: Discussionmentioning

confidence: 70%

Therapeutic mammaplasty is a safe and effective alternative to mastectomy with or without immediate breast reconstruction

Potter

Trickey

Rattay

et al. 2020

British Journal of Surgery

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“…However, our study did not include patients who required completion mastectomy after failed OBC. Previous studies from our unit indicated a completion mastectomy rate between 0 -13.2% of patients treated with OBC indicating a relatively high completion mastectomy rate after initially failed OBC 8,9,14,36,37 . Although these figures cannot be projected to the practice of the whole country, it is conceivable that true incomplete margin rate after OBC is somewhat higher in Scotland.…”

Section: Discussionmentioning

confidence: 75%

“…Current evidence is largely based on single-institution retrospective series [3][4][5][6][7][8][9][10][11][12][13][14][15] . Systematic literature reviews, meta-analyses and reviews further strengthen the evidence base but numbers in many series are small 2, [16][17][18][19][20][21][22][23][24] .…”

Section: Introductionmentioning

confidence: 99%

A population-based audit of surgical practice and outcomes of oncoplastic breast conservations in Scotland – An analysis of 589 patients

Romics

Macaskill

Fernandez

et al. 2018

European Journal of Surgical Oncology

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“…This study was designed and reported in line with STROBE criteria. 20 Methods for data collection in our centers have previously been described. [21][22][23][24] The research was conducted in accordance with the principles of the Declaration of Helsinki.…”

Section: Methodsmentioning

confidence: 99%

Oncological Outcomes and Complications after Volume Replacement Oncoplastic Breast Conservations—The Glasgow Experience

Stallard

Doughty

et al. 2016

Breast Cancer�(Auckl)

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INTRODUCTIONOncoplastic breast conservation surgery (OBCS) combines the principles of surgical oncology and plastic surgery. OBCS has now become a growing option for the treatment of breast cancer and forms a part of breast-conserving therapy (BCT). We sought to investigate and report our experience in two breast units in Glasgow (Victoria Infirmary and Western Infirmary) on volume replacement OBCS.MATERIALS AND METHODSDetails of patients treated with volume replacement OBCS were identified from a prospectively recorded database from November 2010 to October 2015. The clinical records included in the oncoplastic dataset were analyzed for demographics, tumor, treatment characteristics, and recurrences. The data were analyzed for follow-up to determine the pattern and timing of recurrence up to April 2016. The primary outcome of this study was tumor-free margin resection rates, and the secondary outcomes were locoregional and distant recurrence rates as these correlate with the overall oncological safety of volume replacement oncoplastic breast surgery (OPBS).RESULTSA total of 30 volume replacement oncoplastic breast conservation procedures have been carried out in this time period. The mean age of the former group was 51 years. Twice as many patients presented symptomatically than had tumors detected on screening. The mean preoperative tumor size on radiology was 25.4 mm. Patients underwent 13 thoracoepigastric flaps, 5 lateral intercostal artery perforator (LICAP) flaps, 2 thoracodorsal artery perforator (TDAP) flaps, 1 lateral thoracic artery perforator (LTAP) flap, 1 crescent flap volume replacement surgery, and 8 matrix rotations. Two patients had neoadjuvant chemotherapy. Fourteen patients had adjuvant chemotherapy, and all patients were treated with adjuvant radiotherapy. Twenty-two patients were treated with hormonal therapy and four patients were treated with Herceptin. The rate of incomplete excision was 10%. Median follow-up time was 48.5 months. Only one regional recurrence was detected. Eight patients encountered some form of complication.CONCLUSIONThis study continues to show the relative oncological safety of volume replacement oncoplastic conservations as an option for reconstruction in breast cancer patients. Further research is urgently needed to build robust evidence supporting the long-term oncological safety.

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Six-year follow-up of patients treated with oncoplastic reduction mammoplasty: A cohort study

Abstract: Based on these long-term follow-up data, ORM is an oncologically safe treatment option.

Cited by 19 publications

References 35 publications

Therapeutic mammaplasty is a safe and effective alternative to mastectomy with or without immediate breast reconstruction

Therapeutic mammaplasty is a safe and effective alternative to mastectomy with or without immediate breast reconstruction

A population-based audit of surgical practice and outcomes of oncoplastic breast conservations in Scotland – An analysis of 589 patients

Oncological Outcomes and Complications after Volume Replacement Oncoplastic Breast Conservations—The Glasgow Experience

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