The effectiveness of simultaneous oncoplastic breast surgery in patients with locally advanced breast cancer

Abstract

Background: Oncological outcomes of the oncoplastic breast surgery in patients with locally advanced breast cancer (LABC) are not well defined. This study examined the effects of oncoplastic techniques for LABC in terms of localized control and survival. We also evaluated the esthetic results of patients who had undergone oncoplastic breast conservation surgery (OBCS) and their satisfaction with the outcome.

Methods: The files and Medula (Probel Co.) database records of the patients were studied retrospectively. The esthetic evaluation was conducted by a panel. A validated satisfaction study was also performed.

Results: In total, 42 LABC cases (median age 48 years; range 33-69 years) were included. The median observation period was 61 months (range 26-151 months). Neoadjuvant chemotherapy (NACT) was administered in 32 (76%) cases, and a pathologic complete response was observed in 7 (16.7%) cases. The median T size during the post-NACT pathological study was 27 mm (range 0-44 mm). Oncoplastic reduction surgery was performed in 13 cases, a glandular flap in 7, Grisotti flap in 5, and latissimus dorsi flap in 3 cases. The median specimen weight was 198 g (range 103-812 g), and the mean surgical margin length was 8.7 mm (range 5-17 mm). The margin was positive in 7.1% of cases, and the local repetition rate was 14.6%. The total survival rate was 86.6%, and disease-free survival was 59.6%. The rate of excellent and good ratings by the esthetic assessment panel was 79.4%. The satisfaction rate was 88.2%. The early and delayed complication rate was 16.7%.

Conclusions: Oncoplastic techniques are suitable and safe for patients undergoing OBCS. These techniques do not pose a risk to oncological local control. No survival or follow-up problems were detected during the 5-year follow-up period, the esthetic results were acceptable, and the satisfaction rate was high.

Keywords: Aesthetics; Breast cancer; Locally advanced breast cancer; Macromastia; Oncoplastic breast surgery; Oncoplastic surgery; Satisfaction.