A prospective comparative study of locoregional recurrence rate after oncoplastic breast surgery versus wide local excision of breast carcinoma

Background
Breast cancer is the commonest cancer in Egypt in women. There are about 39% of total malignancies in Egyptian females and it is a leading cause of mortality among them.
Objective
The aim of this study was to compare locoregional recurrence rate after oncoplastic breast surgery versus wide local excision of breast carcinoma.
Patients and methods
This prospective study was conducted at Ain Shams University Hospitals on 50 patients, −25 of them underwent oncoplastic breast surgery and −25 underwent wide local excision, as a part of the treatment of breast cancer, to compare the rate of a breast cancer recurrence over 1.6 years starting from December 2018. Approval of the Ethical Committee and written informed consent from all participants were obtained.
Results
Our study included 50 patients, 25 of them underwent wide local excision for stages 1 and 2 breast cancer, the other 25 underwent oncoplastic breast surgery for stages 1 and 2 breast cancer. Our mean age was 44.24±8.13 years (28–60 years). In total, nine (18.0%) had a positive family history of mammary cancer, five (10.0%) patients were diabetic, three (6.0%) patients were hypertensive, the mean size of the tumor was 3.54±1.16 (1–5) cm. Grades of the tumor were grade 1 32 (64.0%), grade 2 11 (22.0%), and grade 3 7 (14.0%); sentinel lymph node biopsy was done in six (12.0%) of patients; there is a high correlation between the closest free margin and the technique of surgery used where 96% of cases undergoing oncoplastic breast conservation surgery had the closest free margin more than 2 cm in comparison to 24% of cases undergoing wide local excision. Regarding recurrence rate, although there are two cases of locoregional recurrence that occurred after wide local excision versus no recurrence in the oncoplastic breast conservation surgery group, this has been of no statistical significance. There is a significant relation between diabetes mellitus and cosmetic outcome, where 20% of diabetic patients have poor cosmetic outcome and 90% of patients with the excellent cosmetic outcome have no comorbidities.
Conclusion
On short-term follow-up done in our study of 1.5 years, there is no significant difference in the recurrence rate of stages 1 and 2 breast cancer after wide local excision and oncoplastic breast surgery, but there has been a significant increase in the size of the closest free margin in oncoplastic breast surgery compared with wide local excision.