Comparison of clinicopathologic, cosmetic and quality of life outcomes in 700 oncoplastic and conventional breast-conserving surgery cases: A single-centre retrospective study

Abstract

Introduction: Limited data is available from studies that directly compare oncoplastic breast surgery and conventional breast-conserving surgery (CBCS) procedures. The aim of this study was to compare three volume displacement oncoplastic breast-conserving surgery (OBCS) techniques to CBCS procedures, providing more evidence and facilitating the standardization of OBCS techniques.

Patients and methods: A retrospective single-centre comparative study was performed between January 2010 and January 2017 involving 758 breast cancer patients. The endpoints for comparison were oncological safety, frequency of complications, initiation time of adjuvant therapy, aesthetic outcome, quality of life and operation time. To compare data, statistical analyses were performed.

Results: The mean follow-up time was 51 months for the OBCS group and 52 months for the CBCS group. The excised weight of the specimens was significantly larger in the OBCS group than in the CBCS group (90 g vs. 63 g). The overall complication rate (5.7% vs. 6.6%), the initiation time of adjuvant therapy (4.2 weeks vs. 4.1 weeks) and the local recurrence rate (2.0% vs. 3.7%) did not differ significantly. Scores for the aesthetic outcome were significantly higher in the OBCS group; however, required longer operation time.

Conclusion: The investigated OBCS procedures allowed the removal of large volumes of breast tissue with improved cosmetic outcomes without delay in adjuvant therapies, maintaining the oncological safety. However, OBCS required longer operation time. Furthermore, the extended radicality of the OBCS could reduce the rate of re-excision and completion mastectomy, although it may result in the overtreatment of some breast cancer patients.

Keywords: Breast cancer; Conventional breast-conserving surgery; Oncoplastic breast-conserving surgery.