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

Chauhan, Ashutosh; Sharma, Mala Mathur

doi:10.1016/j.mjafi.2015.11.001

Cited by 31 publications

(26 citation statements)

References 27 publications

(29 reference statements)

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“…A total of 2,375 studies were initially selected from the literature. Of these, 11 studies [ 10 11 12 13 14 15 16 17 18 19 20 ] were finally included in the meta-analysis. The excluded studies were duplicated studies from different websites, studies with overlapping data, case reports, conference abstracts, and studies based on experimental or non-human subjects ( Figure 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…The OPS techniques used in the included studies were glandular or pedicle flap transfer, wise-pattern procedure, Grisotti procedure, Benelli procedure, donut mastopexy, reduction mammoplasty following lumpectomy, quadrantectomy, or wide local excision. Young patients with breast cancer tended to choose OPS; the average age of patients in the OPS group was lower in seven studies [ 10 12 13 16 17 18 19 ], of which three studies [ 13 18 19 ] reached statistical significance. All the included studies compared the oncological outcomes of BCS and BCS plus OPS for breast cancer, and the major histopathological type was ductal carcinoma (83.8%–71.6%).…”

Section: Resultsmentioning

confidence: 99%

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Comparison of Oncoplastic Breast-Conserving Surgery and Breast-Conserving Surgery Alone: A Meta-Analysis

et al. 2018

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PurposeThe use of oncoplastic reconstruction for breast-conserving surgery (BCS) extends benefits beyond merely minimizing poor cosmetic results. However, the feasibility and oncological safety of oncoplastic surgery (OPS) are controversial.MethodsThis meta-analysis aimed to compare the short-term and long-term oncological outcomes of BCS alone and BCS plus OPS. Relevant studies published before July 2017 in the Embase, the Cochrane Library, PubMed, and Web of Science databases were screened and collected. The meta-analysis was performed using STATA software (Stata Corp.).ResultsA total of 3,789 patients from 11 studies were included, with 2,691 patients in the BCS-alone group and 1,098 patients in the BCS plus OPS group. The demographics were similar between both groups, and no significant difference was observed in pathological T and N stages between the two groups. Re-excision was less common (relative risk [RR], 0.66; p=0.009) and the positive-margin rate was lower, but not significantly (RR, 0.83; p=0.191), in the BCS plus OPS group than in the BCS-alone group. The local and distal recurrence rates were similar in both groups. Both disease-free survival (hazard ratio [HR], 1.19; 95% confidence interval [CI], 0.96–1.49; p=0.112) and overall survival (HR, 1.14; 95% CI, 0.76–1.69; p=0.527) did not differ between the two groups.ConclusionA combination of BCS and OPS is preferred over BCS alone for decreasing re-excisions and provides similar long-term survival as BCS alone in patients with breast cancer.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Comparison of Oncoplastic Breast-Conserving Surgery and Breast-Conserving Surgery Alone: A Meta-Analysis

et al. 2018

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“…Most studies comparing OBCS with sBCS have reported no difference in surgical complications between the groups. 7 , 17 Carter et al compared complication rates in 9,861 patients treated with sBCS, OBCs, Mastectomy only (Mx) and mastectomy plus immediate reconstruction (Mx + IR). 5 OBCS had a lower seroma rate (13%) than sBCS but wound-related complications (4.8%) were statistically higher in OBCS.…”

Section: Introduction – Obcs: Rationale Definitiomentioning

confidence: 99%

Oncological safety and cosmetic outcomes in oncoplastic breast conservation surgery, a review of the best level of evidence literature

Campbell

Romics

2017

BCTT

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Oncoplastic breast conservation surgery (OBCS) is increasingly becoming part of routine breast cancer surgical management. OBCS may be viewed as an extension of standard breast conservation surgery for resecting tumors of larger sizes without compromising on cosmetic outcome, or as an alternative to mastectomy. High quality evidence to support the oncological safety and benefits of OBCS is lacking. This review will focus on the best available level of evidence and address key issues regarding oncological safety in OBCS, such as tumor resection margins and re-excision rates, local recurrence and patient outcome, postoperative complications and adjuvant therapy delivery, and briefly discuss cosmetic outcome in OBCS. Comparative observational studies and systematic review report no poorer outcomes compared with standard breast conservation surgery. More evidence needs to be generated to support the oncological safety and improved aesthetic outcome. Prospective data collection will significantly contribute to the generation of stronger evidence.

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“…Oncoplasty was first described by Audretsch in 1998 as the incorporation of principles of plastic surgery for removal of tumours of the breast with adequate surgical margin along with immediate breast reconstruction [19]. Breast conservation alone leads to significant deformity of the breast, and margin clearance may also get compromised, but when breast conservation is performed by oncoplastic methods, the outcome in terms of cosmesis is much better and wider margins could be achieved [20][21][22]. Moreover, with oncoplasty and partial breast reconstruction, BCS can be even offered to selected patients with multifocal lesions in the same quadrant [23].…”

Section: Discussionmentioning

confidence: 99%

Reconstruction in Breast Conservation Therapy—Single Tertiary Care Institution Experience with 472 Patients

Agrawal

Mehta

Goel³

et al. 2017

Indian J Surg Oncol

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Breast conservation therapy (BCT) is now internationally accepted treatment for early breast cancer. Despite of high incidence of carcinoma breast in India, BCT rates are very low as compared to the west. In this article, we wish to share our experience of breast conservation with oncoplasty in Indian women. A retrospective analysis of case records of patients treated with oncoplastic breast conservation from January 2009 to June 2014 in a single surgical oncology unit in a tertiary cancer institute. Demographic patient data, stage of disease, location of primary tumour, use of neo-adjuvant chemotherapy if received, tumour size and breast size ratio, reconstruction method used, post-operative complications and aesthetic score of patients were analysed. Various methods of oncoplasty and partial breast reconstruction used are discussed. Four hundred and seventy-two patient records were found suitable for analysis. Most common stage of presentation was T2N0 in 189 patients (40%). Forty-one patients received neo-adjuvant chemotherapy (NACT). Tumour arising in upper outer quadrant was most common site, seen in 268 (56.7%). The most common method of reconstruction was volume displacement, done in 57.6% patients. Overall surgical complications included wound infection with or without dehiscence, seroma formation, partial flap necrosis and fat necrosis. Cosmesis was found to be excellent in 23.09% and good in 58.47% at 6-month follow-up. Breast conservation with oncoplasty is oncologically safe for early breast cancer treatment and has good cosmetic outcome with high patient satisfaction rates. Its practice should be encouraged in Indian setup also.

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

Abstract: m e d i c a l j o u r n a l a r m e d f o r c e s i n d i a 7 2 ( 2 0 1 6 ) 1 2 -1 8 a r t

Cited by 31 publications

References 27 publications

Comparison of Oncoplastic Breast-Conserving Surgery and Breast-Conserving Surgery Alone: A Meta-Analysis

Comparison of Oncoplastic Breast-Conserving Surgery and Breast-Conserving Surgery Alone: A Meta-Analysis

Oncological safety and cosmetic outcomes in oncoplastic breast conservation surgery, a review of the best level of evidence literature

Reconstruction in Breast Conservation Therapy—Single Tertiary Care Institution Experience with 472 Patients

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