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. 2016 Jan;72(1):12-8.
doi: 10.1016/j.mjafi.2015.11.001. Epub 2015 Dec 13.

Evaluation of surgical outcomes following oncoplastic breast surgery in early breast cancer and comparison with conventional breast conservation surgery

Ashutosh Chauhan  1 , Mala Mathur Sharma  2
Affiliations

Evaluation of surgical outcomes following oncoplastic breast surgery in early breast cancer and comparison with conventional breast conservation surgery

Ashutosh Chauhan et al. Med J Armed Forces India. 2016 Jan.

Abstract

Background: The aim of this study was to determine whether oncoplastic breast surgery (OBS) ensures better tumour resection than conventional breast conservation surgery (BCS).

Methods: A prospective comparative study, conducted over a 3-year period, enrolled patients with early breast cancer who underwent OBS. The total volume of glandular resection, tumour volume resection and width of the margins obtained were noted. The incidence of complications, requirement of revision surgery and locoregional recurrence during follow-up period were also noted. The data were compared with matched controls who had undergone convention BCS in the past.

Results: Thirty-three patients underwent oncoplastic surgery and the data was compared with 46 patients of conventional breast conservation. The mean volume of specimen was higher in the oncoplastic group (173.5 cm(3) vs 101.4 cm(3), p = 0.03) though the tumour volume excised was similar (43.2 cm(3) vs 36.4 cm(3), p = 0.14). The mean margin widths were larger in the oncoplastic group (14 mm vs 6 mm, p = 0.01). There were more instances of close and positive margins seen in conventional BCS groups. The incidence of complication rate was similar. Median follow-up 18 months for oncoplasty group showed no cases of locoregional recurrence while in median follow-up of 38 months for conventional BCS group, six cases of locoregional relapse were noted.

Conclusions: Oncoplastic surgery results in excision of larger volume of breast tissue and correspondingly obtain wider surgical margins as compared to conventional BCS. Longer follow-up is required to determine if wider resection translates into better locoregional control.

Keywords: Breast conservation; Oncoplasty surgery; Surgical margins.

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Figures

Fig. 1
Fig. 1
Oncoplasty volume displacement technique: A 3.5 cm upper outer quadrant tumour addressed by lateral mammoplasty incision.
Fig. 2
Fig. 2
Oncoplasty volume replacement technique: A 2.5 cm central quadrant tumour addressed by wide local excision and mini LD flap inset.
Fig. 3
Fig. 3
Conventional breast conservation surgery: bad cosmetic results seen after surgery in (a) a central quadrant tumour, (b) a upper inner quadrant tumour, (c) lower inner quadrant tumour and (d) lower outer quadrant tumour.
See this image and copyright information in PMC

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