Oncoplastic surgery in breast conservation: a prospective evaluation of the patients, techniques, and oncologic outcomes

Am J Surg. 2014 Nov;208(5):727-734. doi: 10.1016/j.amjsurg.2014.04.005. Epub 2014 Jun 20.

Abstract

Background: The oncologic efficacy of breast-conserving therapies has been established in recent decades. Oncoplastic breast surgery (OBS), as a leap forward in breast conservation, offers concomitant techniques of oncologic and plastic surgeries that grant better esthetic results. The outcomes of our oncoplastic surgeries from 2007 to 2012 are reported.

Methods: A series of 258 cases with breast masses (18 benign and 240 carcinomas) were operated on by OBS techniques and prospectively followed. Neoadjuvant and adjuvant oncologic treatments were also delivered as indicated.

Results: Free margins were obtained in 95% of cancer patients. During the 26 months of follow-up, local recurrence happened in 7 (2.9%) patients, of which 1 underwent oncologic therapies and 6 underwent completion mastectomy. Complications postponed adjuvant therapies in 3 (1.2%) patients. Postsurgically, metastases were diagnosed in 8 (3.3%) patients. Two patients (.8%) died of cancer.

Conclusions: Outcomes of OBS are oncologically acceptable with low frequencies of positive margins and recurrence, while cosmetic results are much improved by OBS.

Keywords: Breast cancer; Breast conservation; Oncologic outcomes; Oncoplastic breast surgery.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Breast Neoplasms / mortality
  • Breast Neoplasms / surgery*
  • Carcinoma / mortality
  • Carcinoma / surgery
  • Female
  • Fibroadenoma / mortality
  • Fibroadenoma / surgery
  • Fibrocystic Breast Disease / mortality
  • Fibrocystic Breast Disease / surgery
  • Follow-Up Studies
  • Granulomatous Mastitis / mortality
  • Granulomatous Mastitis / surgery
  • Humans
  • Mastectomy, Radical / statistics & numerical data
  • Mastectomy, Segmental / methods*
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Phyllodes Tumor / mortality
  • Phyllodes Tumor / surgery
  • Prospective Studies
  • Reoperation / statistics & numerical data
  • Treatment Outcome