Comparing oncoplastic breast reduction with immediate symmetry surgery to standard breast reduction surgery: Are postoperative complications worse?

Pawlak, Natalie; Karamchandani, Manish; Wareham, Carly; Gaffney, Kerry; Zaccardelli, Alessandra; Nardello, Salvatore; Persing, Sarah; Chatterjee, Abhishek; Homsy, Christopher

doi:10.1002/jso.27009

Cited by 6 publications

(6 citation statements)

References 19 publications

(43 reference statements)

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“…Nine articles were identified that met inclusion criteria, representing 1715 patients (Table 1) with surgery occurring between 1995 and 2020. [11][12][13][14][15][16][17][18][19] Reported mean follow-up ranged from 9.4 to 84 months. Mean patient age ranged from 51.9 to 59.6 years and mean body mass index had a range of 24.2-33.5 kg/m 2 (Table 2).…”

Section: Resultsmentioning

confidence: 99%

Oncoplastic Breast Reduction: A Systematic Review of Postoperative Complications

Benedict,

Brown,

Berry

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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Background: Breast-conserving therapy with oncoplastic reduction is a useful strategy for partial mastectomy defect reconstruction. The most recently published systematic review of oncoplastic breast reduction outcomes from 2015 showed wound dehiscence in 4.3%, hematoma in 0.9%, infection in 2.8%, and nipple necrosis in 0.9% of patients. We performed a systematic review of oncoplastic breast reduction literature, comparing outcomes and complication rates reported over the past 8 years. Methods: Studies describing the use of oncoplastic breast reduction and discussion of postoperative complications were included. The primary outcome assessed was the postoperative complication rate; secondary outcomes analyzed were rates of margin expansion, completion mastectomy, and delays in adjuvant therapy due to complications. Results: Nine articles met inclusion criteria, resulting in 1715 oncoplastic breast reduction patients. The mean rate of hematoma was 3%, nipple necrosis was 2%, dehiscence was 4%, infection was 3%, and seroma was 2%. The need for re-excision of margins occurred in 8% of patients, and completion mastectomy in 2%. Finally, delay in adjuvant treatment due to a postoperative complication occurred in 4% of patients. Conclusions: Oncoplastic breast reduction is an excellent option for many patients undergoing breast-conserving therapy; however, postoperative complications can delay adjuvant radiation therapy. Results of this systematic literature review over the past 8 years showed a slight increase in complication rate compared to the most recent systematic review from 2015. With increased popularity and surgeon familiarity, oncoplastic breast reduction remains a viable option for reconstruction of partial mastectomy defects despite a slight increase in complication rate.

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Section: Resultsmentioning

confidence: 99%

Oncoplastic Breast Reduction: A Systematic Review of Postoperative Complications

Benedict,

Brown,

Berry

et al. 2023

Plastic and Reconstructive Surgery - Global Open

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“…OPS is a safe and accepted option for breast cancer surgery 15,16 . As such, efforts should be made to improve accessibility to oncoplastic techniques in the management of breast cancer patients in the United States 17 .…”

Section: Discussionmentioning

confidence: 99%

“…OPS is a safe and accepted option for breast cancer surgery. 15,16 As such, efforts should be made to improve accessibility to oncoplastic techniques in the management of breast cancer patients in the United States. 17 As societies begin to investigate training surgeons in OPS, learning curve studies such as ours demonstrating results are important in guiding teaching programs.…”

Section: Discussionmentioning

confidence: 99%

The adoption of oncoplastic surgery: Is there a learning curve?

Karamchandani

Jonczyk

Cruz-Ku

et al. 2023

Journal of Surgical Oncology

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Introduction: Oncoplastic surgery (OPS) is a form of breast conservation surgery involving partial mastectomy followed by volume displacement or replacement surgery. As the field of OPS is growing, we sought to determine if there was a learning curve to this surgery.Methods: A retrospective chart review was conducted of all patients who underwent OPS over a 6-year period with a single surgeon formally trained in both Plastic Surgery and Breast Oncology. Cumulative summation analysis (CUSUM) was performed on mean operative time to generate the learning curve and learning curve phases. Outcomes were compared between phases to determine significance.Results: Mean operative time decreased significantly across the 6-year period, generating three distinct learning curve phases: Learner phase (cases 1−23), Competence phase (24−73), and Mastery phase (74 and greater). The overall positive margin rate was 10.9% and there was no significant difference in rates between phases (p = 0.49). Overall complication rates, reoperation rates, and locoregional recurrence remained the same across all phases (p = 0.16; p = 0.65; p = 0.41). The rate of partial nipple loss decreased between phases (p = 0.02). Conclusion:As with many complex operations, there does appear to be a learning curve with OPS, as the operative time and the rates of partial nipple loss decreased over time.

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“…Although patients undergoing immediate oncoplastic breast reduction are usually older and with a higher number of comorbidities compared to standard reduction mammoplasty, they show a similar safety profile without significant delays to adjuvant therapy [16]. The same is not verified when comparing immediate and delayed breast therapeutic reduction complications when radiotherapy is performed.…”

Section: Discussionmentioning

confidence: 99%

Therapeutic Reduction Mammoplasty: Experience of a Single Institute

Azevedo¹,

Chaves²,

Coelho³

et al. 2023

Cureus

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Introduction: Breast cancer is the most common malignancy in women worldwide as reported by the World Health Organization. The concept of oncoplastic breast surgery appeared as an extension of breastconserving surgery, applying breast reduction techniques with more acceptable aesthetic and functional outcomes. The purpose of the present study was to describe the breast cancer population of a single institute submitted to lumpectomy and bilateral immediate breast reduction or mastopexy and its complications.Material and Methods: This is a retrospective observational study including patients submitted to lumpectomy and immediate bilateral breast reduction or mastopexy. Patients and tumour characteristics, surgical technique, complications, follow-up period, and recurrence data were obtained and analyzed.Results: A total of 49 patients were submitted to lumpectomy and bilateral breast therapeutic reduction/mastopexy, with a mean age of 56.47 ±8.58 years and a mean body mass index of 28.68kg/m 2 ±3.94 kg/m² between January 2019 and December 2021. Invasive tumours of no specific type, associated or not, with carcinoma intraductal in situ were the most common histological type corresponding to almost 80% of the cases with T1 stage corresponding to more than half of the cases. Sixteen percent of the patients had early minor complications with wound dehiscence associated with wound delayed healing, corresponding to 75% of the cases. Body mass index had a statistical difference between groups (p=0,006, ttest).Conclusions: The low rates of minor and major complications show that immediate therapeutic breast reduction can be a suitable approach in selected cases.

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Comparing oncoplastic breast reduction with immediate symmetry surgery to standard breast reduction surgery: Are postoperative complications worse?

Cited by 6 publications

References 19 publications

Oncoplastic Breast Reduction: A Systematic Review of Postoperative Complications

Oncoplastic Breast Reduction: A Systematic Review of Postoperative Complications

The adoption of oncoplastic surgery: Is there a learning curve?

Therapeutic Reduction Mammoplasty: Experience of a Single Institute

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