The Integrated Evaluation of the Results of Oncoplastic Surgery for Locally Advanced Breast Cancer

Abstract

The optimal surgical management of locally advanced breast cancer (LABC) remains undefined. The aim of the study was to obtain long-term results of oncoplastic surgery in terms of overall survival, loco-regional recurrence, and quality of life in case of LABC. Prospective cohort study enrolled 60 patients with stage III breast cancer. Forty-two (70%) patients received neo-adjuvant chemotherapy, 28 patients were considered suitable for surgery as initial treatment option. Type II oncoplastic surgery was performed for all patients: hemimastectomy and breast reconstruction with latissimus dorsi flap - for 29 (48.3%), lumpectomy - 31 (51.7%), and reconstruction with subaxillary flap for four (6.7%), with bilateral reduction mammoplasty - 14 (23.3%) and with J-plastic - 13 (21.7%) patients. Adjuvant chemotherapy and hormonal therapy followed surgery for all, except one, patients. Sequential radiotherapy was administered for all patients. The mean period of follow-up was 86 months. Postoperative morbidity rate was 5%. Local-regional recurrence was detected in six (10%) patients. After reoperation no local relapse was diagnosed. However, three of these patients had systemic dissemination of the disease. Distant metastasis was detected in 23 (38.3%) patients. Distant metastasis-free survival at 5 years was 61.7%. Fourteen patients died (23.3%). A total of 87.2% of the patients had good and excellent esthetic outcome. Oncoplastic breast-conserving surgery can be proposed for selected patients with LABC with acceptable complication, local recurrence rate, and good esthetic results.

Palliation of Ulcerative Breast Lesions with Radiation

“…In developed countries with routine screening and awareness, breast cancer is usually detected early and presents as earlystage breast cancer. Locally advanced breast cancer (LABC), defined as primary tumor greater than 5 cm, with or without nodal involvement, only occurs in 5% to 10% of cases in developed countries (1)(2)(3)(4)(5)(6)(7). However, these numbers are much higher in the developing world due to lack of adequate screening, awareness, and accessibility to healthcare resources (1,3,4,7).…”

Oncoplastic Breast Surgery after Neoadjuvant Chemotherapy Replacing Mastectomy in Locally Advanced Breast Cancer (LABC): Single Institute Experience

“…Three cases had surgical complications in our study with delay in the adjuvant therapy in 2 cases (6%), Mazouni et al [26] reported complications rate 16.7% but most of them were minor, Bogusevicius et al [22] reported complication rate 5%, with delay in adjuvant therapy in one case.…”

“…Clough et al [21] had 4 years follow up with 9.5% LR rate. Bogusevicius et al [22] said that six patients (10%) had locoregional recurrence in mean follow up 86 months.…”

Evaluation of Surgical Outcomes of Oncoplasty Breast Surgery in Locally Advanced Breast Cancer and Comparison with Conventional Breast Conservation Surgery

“…Whether the wider margins enabled by OBS results in lower incidence of locoregional recurrence remains to be seen on a longer follow-up. Other studies with longer follow-up have indicated a recurrence rates of 6-10 % following OBS which is comparable to that of conventional BCS [20,21]. The study may be criticized on the aspect that it is not a prospective, randomized study; rather, it relies on comparing OBS with a retrospective cohort.…”