<b><i>Background:</i></b> Breast-conserving treatment (BCT) provides better quality of life (QL) than mastectomy without reconstruction. Oncoplastic surgery (OS) encompasses a series of surgical techniques, increasing the indications for BCT, but few studies have evaluated the impact on QL in patients who undergo BCT with OS. <b><i>Materials and Methods:</i></b> A prospective, cross-sectional study was conducted in women who underwent BCT. We evaluated the characteristics of patients who underwent BCT with and without OS and the associated QL. QL was assessed through the EORTC QLQ-30, EORTC QLQ-BR23, and Breast Cancer Treatment Outcome Scale (BCTOS) questionnaires. <b><i>Results:</i></b> A total of 300 patients underwent BCT, 72 underwent breast OS, and 37 underwent bilateral surgery. Patients who underwent OS were younger (<i>p</i> = 0.004), had a higher level of education (<i>p</i> = 0.01), had a smaller time interval since the end of treatment (<i>p</i> = 0.02), had tumours with greater dimensions (<i>p</i> = 0.003), and were more likely to receive neoadjuvant chemotherapy (<i>p</i> = 0.05). Based on the QL questionnaires, no difference was observed between the groups. Breast symmetry was not associated with high patient satisfaction (<i>p</i> = 0.55). <b><i>Conclusion:</i></b> Despite the fact that OS was performed in patients with worse tumour conditions and in more demanding patients, OS allowed similar cosmetic results to classical BCT.
The authors presented a case of a patient with locally advanced breast cancer, with mammary and axillary localization, initially considered non-resectable, with good response after neoadjuvant chemotherapy. Due to the location of the lesion and the need for extensive resection, radical mastectomy was performed, associated with reconstruction with myocutaneous flap of the vertical rectus abdominis muscle. Different therapeutic options, the reasons that determine this choice, and local long-term control were discussed.
Breast-conserving treatment was established as an oncologically safe procedure for breast cancer. However, the cosmetic outcomes of breast-conserving treatments are often unsatisfactory. In this scenario, oncoplastic breast-conserving surgery incorporated plastic surgery concepts and techniques into the oncological treatment in order to ensure better cosmesis, thus increasing the indications for breast-conserving treatment. At the same time, oncoplastic breast-conserving surgery is usually presented as a generic term, which should be evaluated taking many aspects into account: indication, patient selection, the surgery itself, cosmetic quality, and quality of life — data that are still scarce in the literature.
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