Therapeutic mammoplasty as a viable surgical approach in Breast Cancer Patients from India: A Single Institutional Audit

Abstract

Introduction Therapeutic Mammoplasty (TM) is a Oncoplastic Breast Surgery (OBS) technique suitable for medium-to-large breasts with ptosis with large or multifocal/multicentric (MF/MC) tumors. Several studies have indicated that TM expands the scope, extent, and application of breast conservation surgery. This report describes in detail TM outcomes in Indian breast cancer (BC) patients. Methods From our single institutional cohort (n = 211), we present data related to surgical techniques, clinical management, oncological safety, cosmetic and patient reported outcomes (PROMs, based on Breast-Q questionnaire) from BC patients who underwent TM (categorized as simple, complex, extreme and split-reduction type) Results Mean age at diagnosis was 48.7 years. Majority of these patients had advanced stage (II/III) disease. 178 patients consented and 171 completed 1 year follow-up from 3 main groups (a) simple (n=87) (b) complex (n =39) and (c) extreme TM (n = 49). The post-operative complication rates were low (<10%) without any delay in adjuvant treatment. Cosmetic scores were good-to-excellent (n = 154). Post- 1-year PROMs (n =149) revealed good-to-excellent score for satisfaction with breast, cosmetic outcome and psychosocial well-being for all TM types. Conclusion Our study is a first detailed report describing a multi-factorial audit in TM single institutional cohort in Indian BC patients. We propose that our TM technique/s may be optimally suited for BC scenarios common in India namely (a) advanced stage BC patients with moderate-to-large breasts with mild/severe ptosis (b) multifocal, multicentric tumors (c) LABC at initial presentation.