Comparison between conventional and oncoplastic breast surgeries regarding resection margins and local recurrences in breast cancer: Retrospective study

Background
Breast cancer is the most common cancer in women and the second-leading cause of cancer-related fatalities globally. Breast-conserving surgery (BCS) is the primary surgical treatment for early-stage breast cancer, with oncoplastic BCS techniques expanding its possibilities. BCS offers a higher quality of life compared to mastectomy. However, it has two absolute contraindications: the inability to produce negative margins without deforming the breast and inflammatory breast cancer. Oncoplastic displacement and replacement BCS allow resections of up to 50% of breast volume without creating deformity. Positive surgical margins often require a second procedure, which can increase pain, complications, and medical expenses.
Patient and methods
This retrospective cohort study analyzed 310 patients with primary invasive breast cancer or DCIS who underwent conventional or oncoplastic breast cancer surgery. Most patients underwent lateral and therapeutic reduction mammoplasties. Other techniques included LD flap, TDAP flap, mini-LD muscle flap, ICAP flap, grisotti flap, LICAP flap, and modified round block technique. Oncoplastic techniques were tailored based on breast cup size, tumor size, tumor location, and patient preference. Wide local excision of the tumor with free margins was confirmed through intraoperative frozen sections.
Result
The mean weight of the specimen was 55.89 gm in the conventional group and 101.55 gm in the oncoplastic group. The mean operative time was 65.9 min in the conventional group, while the oncoplastic group had 72.58 min Complications included seroma, hematoma, wound infection, wound dehiscence, lymphedema, and partial nipple necrosis. The aesthetic outcome was excellent, with 132 patients satisfied with their results in the oncoplastic group compared to 90 in the conventional group.
Conclusion
Oncoplastic breast surgeries are safe, feasible and became the standard of care in breast cancer. Oncoplastic breast surgeries are of choice in cases of multifocal cancer. People who performed oncoplastic breast surgeries had wider free margins, much more aesthetic outcome, better psychological status, less redo surgery, less late deformities, more time consuming, more wound complications improved with frequent dressing, and did not causea delay in the adjuvant therapy, more requirement for contralateral symmetrizing surgery.