Oncoplastic breast surgery does not delay the onset of adjuvant chemotherapy: a population-based study

Klit, Anders; Tvedskov, Tove Filtenborg; Kroman, Niels; Elberg, Jens Jørgen; Ejlertsen, Bent; Henriksen, Trine

doi:10.1080/0284186x.2017.1281437

Cited by 20 publications

(12 citation statements)

References 12 publications

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“…The mean time from referral to surgery ranged from 25 to 30 days, being shorter in the sMRI group and longest in the WLE group. However, the time from referral to surgery was longer in our population than in other Nordic studies (17e24 days) [29,30]. In this study, patients in sMRI Group had the shortest waiting time (25.5 days), even though they all needed to undergo further evaluation and more preoperative studies, including MRI.…”

Section: Group-1mentioning

confidence: 51%

Can supine breast magnetic resonance imaging help hit the target in extreme oncoplastic surgery?

Joukainen

Okuma

Kaarela

et al. 2021

European Journal of Surgical Oncology

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Objectives: To evaluate the clinical value of supine magnetic resonance imaging (MRI) for tumor localization in breast cancer patients with large or multifocal tumors detected by prone MRI, scheduled for oncoplastic breast conserving surgery (OBCS). Outcomes were compared with those of patients who underwent wide local excision (WLE) or OBCS without MRI guidance. Methods: Over a 2-year period, consecutive patients with large or multifocal disease scheduled for OBCS with MRI-only findings were invited to participate (Group-1). Supplementary supine MRI was performed, and tumor margins were marked in the surgical position. Consecutive patients with early, nonpalpable breast cancer who underwent WLE (Group-2) or OBCS (Group-3) were included for comparisons. The primary outcome was reoperation due to an insufficient margin. Secondary outcomes included surgical complications and delayed adjuvant treatment. Results: Altogether, 102 breasts (98 patients) were analyzed. All preoperative demographic data were comparable among the three groups. Multifocality, tumor-to-breast volume ratio, and the volume of excised breast tissue were significantly greater in Group-1 than in Groups-2 and 3. Operation time was longer and the need for axillary clearance or surgery for both breasts was more common in Groups-1 and 3 than in Group-2. Adequate margins were achieved in all patients in Groups-1 and 2, and one patient underwent re-excision in Group-3. Conclusions: Supine MRI in the surgical position is a new, promising method to localize multifocal, large tumors visible on MRI. Its short-term outcomes were comparable with those of conventional WLE and OBCS.

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Section: Group-1mentioning

confidence: 51%

Can supine breast magnetic resonance imaging help hit the target in extreme oncoplastic surgery?

Joukainen

Okuma

Kaarela

et al. 2021

European Journal of Surgical Oncology

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“…29 A population based study conducted at Denmark also concluded that oncoplastic breast surgery does not cause any delay in the start of chemotherapy in comparison with mastectomy or lumpectomy. 30 Cosmetic results as scored by the patients were excellent, good, fair and satisfactory in 72%, 18.7% and 6.4% & 3.1 % patients respectively with no bad score given by any patient. This shows an overall mean of 4.57±0.75 (range 2-5), equivalent to 90 % satisfaction with the cosmetic appearance.…”

Section: Discussionmentioning

confidence: 72%

Oncological and Cosmetic outcome of Oncoplastic breast surgery.

Saleem

Javed

Rehman

et al. 2019

TPMJ

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Objectives: Oncoplastic breast surgery (OBS) is a revolutionary approach for managing breast cancer. This manuscript aimed to assess the oncological and cosmetic outcomes of OBS in breast cancer. Study Design: Descriptive, prospective study. Setting: Department of Surgery, Madina Teaching Hospital, Faisalabad. Period: January 2018 to June 2019. Material & Methods: Females with invasive breast cancer having 5-6 cm tumour size, Locally advanced tumour after chemotherapy, single tumour and patients < 70 years were included; while patients with fixed tumours, high tumour to breast size ratio, multiple axillary lymph nodes, metastatic cancer & patient’s choice for mastectomy were excluded. Oncological outcome was assessed by; Margin involvement, time lag for chemotherapy, local recurrence and distant metastasis. Cosmetic outcome was detected by score given by patient and an independent surgeon. Results: Thirty two female patients underwent OBS. Mean age of patients was 46.56 yr (SD =10.23). Six patients (18.8%) had central tumors. 3 patients were post neoadjuvant chemotherapy. In 28 patients volume displacement (VD) surgery; while in 4 patients volume replacement (VR) using different flaps like LICAP flap were done. Oncological outcome showed positive margin in one case only, in all other cases clear margins were found. Chemotherapy start time varied from 3 to 8 weeks after surgery (Mean=31.3 days). Delayed time was associated with high BMI and diabetes (P<0.05). Local recurrence or distant metastasis was not noticed in any case. Majority of the patients and surgeon (90%) were satisfied with cosmetic outcome. Conclusion: Oncoplastic Breast surgery is a unique approach to conserve breast even in larger tumours without compromise on oncological principles and cosmesis.

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“…Hitherto reported outcomes will therefore need to continue to improve in the current social‐media age especially with the increased availability of OPBS skills in the UK. Any concerns that OPBS may delay institution of adjuvant therapies is not evidence‐based and the fact that OPBS practice has only grown in the setting of strict quality‐assured breast screening pathways is testimony against the concerns. A population study derived from the robust Danish cancer registry comparing OPBS with simple BCS and mastectomy has mitigated some of these concerns …”

Section: Breast Anatomy Tumor Factors and Surgical Technique: Diffementioning

confidence: 99%

“…The immediate effect of RT in OPBS remains the same as in simple BCS, ie, erythema, epidermolysis, etc. There is no evidence that OPBS delays institution of adjuvant therapy or increases the difficulty of whole breast RT. In addition, since the OPBS is a phenomenon in the last 10‐15 years .…”

Section: Modern Opbs Techniques To Minimize Adverse Aestheticsmentioning

confidence: 99%

Oncoplastic breast surgery and radiotherapy-Adverse aesthetic outcomes, proposed classification of aesthetic components, and causality attribution

Agrawal

2019

Breast J

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The aim of this paper is to discuss and understand the interplay of surgical and radiotherapy (RT) techniques that potentially affect the aesthetic outcomes following breast conservation treatment. It reviews the reported cosmetic outcomes within the practice‐changing RT trials incorporating varied fractionation regimes as well as sequence (before, during, or after surgery) over the past two decades. The paper importantly highlights an overall improvement in breast surgical techniques particularly oncoplastic breast conservation techniques due to dedicated and streamlined training of late. Hence, erstwhile complications or sequel of breast surgery and associated post‐RT aesthetic concerns may not be of the same variety or magnitude that were noted in the past. Paper thus concludes by highlighting the paradigm shift in the breast surgical practice that will have a bearing on the accuracy of RT outcomes assessed (within or out with clinical trials) with implications as a potential research and outcomes assessment gap.

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Oncoplastic breast surgery does not delay the onset of adjuvant chemotherapy: a population-based study

Abstract: Our study shows that oncoplastic breast surgery does not delay the onset of adjuvant chemotherapy in comparison with mastectomy and lumpectomy. Accordingly, patients should not be excluded from treatment with oncoplastic breast surgery due to concerns of delay in adjuvant chemotherapy.

Cited by 20 publications

References 12 publications

Can supine breast magnetic resonance imaging help hit the target in extreme oncoplastic surgery?

Can supine breast magnetic resonance imaging help hit the target in extreme oncoplastic surgery?

Oncological and Cosmetic outcome of Oncoplastic breast surgery.

Oncoplastic breast surgery and radiotherapy-Adverse aesthetic outcomes, proposed classification of aesthetic components, and causality attribution

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