Oncoplastic breast conservation surgery is oncologically safe when compared to wide local excision and mastectomy |
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| Institution: | 1. Department of Surgery, New Victoria Hospital Glasgow, UK;2. Department of Plastic Surgery, Royal Infirmary Glasgow, UK;3. Department of Surgery, Gartnavel General Hospital Glasgow, UK;4. Department of Pathology, Queen Elizabeth University Hospital, UK;1. National Institute of Oncology, Department of Breast and Sarcoma Surgery, Ráth György Str. 7-9, 1122 Budapest, Hungary;2. National Institute of Oncology, Department of Radiological Diagnostics, Ráth György Str. 7-9, 1122 Budapest, Hungary;3. National Institute of Oncology, Department of Surgical and Molecular Pathology, Ráth György Str. 7-9, 1122 Budapest, Hungary;4. National Institute of Oncology, Department of Radiotherapy, Ráth György Str. 7-9, 1122 Budapest, Hungary;5. National Institute of Oncology, National Cancer Registry, Ráth György Str. 7-9, 1122 Budapest, Hungary;6. Guy''s and St Thomas'' Hospitals NHS Foundation Trust, Department of Breast Surgery, Great Maze Pond, London SE1 9RT, United Kingdom;7. National Institute of Oncology, Ráth György Str. 7-9, 1122 Budapest, Hungary;1. Department of Radiology, Institut Curie, 26 rue d’Ulm, 75005 Paris, France;2. Department of Surgical Oncology, Institut Curie, 26 rue d’Ulm, 75005 Paris, France;3. Department of Public Health, Institut Curie, 26 rue d’Ulm, 75005 Paris, France;1. European Breast Center – Dr. Rezai, Hans-Günther-Sohl-Str.6-10, D-40235 Düsseldorf, Germany;2. University Medical Center Cologne, Kerpener Str. 34, D-50931 Cologne, Germany;3. University Hospital of Essen, Women''s Department, Hufelandstr.55, D-45147 Essen, Germany;1. Multidisciplinary Breast Unit, Azienda Ospedaliera Cannizzaro, Catania, Italy;2. G.RE.T.A. Group for Reconstructive and Therapeutic Advancements, Milan, Naples, Catania, Italy;3. International Fellowship Mr G Querci Della Rovere, Italy;4. University of Milan, Milan, Italy;1. Cancer Registry of Norway, Oslo, Norway;2. Oslo and Akershus University College of Applied Sciences, Oslo, Norway;3. Department of Surgery, Haukeland University Hospital, Bergen, Norway;4. National Advisory Unit for Women''s Health, Oslo University Hospital, Oslo, Norway;5. Centre for Cancer Biomarkers CCBIO, Department of Clinical Medicine, Section for Pathology, University of Bergen, Norway;6. Department of Pathology, Haukeland University Hospital, Bergen, Norway |
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| Abstract: | BackgroundSupport for the oncological safety of oncoplastic breast conservation surgery (OBCS) is mostly based on evidence comparing recurrence rates after OBCS to wide local excision (WLE). However, OBCS is often indicated for larger cancers and oncological results should also be compared to patients treated with mastectomy. In this study we compared recurrence and survival following OBCS, mastectomy and WLE.MethodsPatients treated with OBCS between 2009 and 2012 were identified from a prospectively maintained database. For comparison, consecutive patients treated with WLE or mastectomy with or without immediate reconstruction (Ms ± IR) over the same time period were identified. Histological variables of patients were compared using Fisher Exact or Chi squared tests, and recurrence and survival were compared using Kaplan-Meier and Cox regression survival analysis.Results980 patients' data were analysed (OBCS: n = 104; WLE: n = 558; Ms ± IR: n = 318). Tumour size, grade, nodal status, ER, and PR expression of patients treated with OBCS were all significantly more adverse compared with patients treated with WLE (p < 0.001). These histological variables were similar in patients treated with Ms ± IR and OBCS. 5-year local recurrence rates were similar in all three groups (WLE: 3.4 per cent, OBCS: 2 per cent, Ms ± IR: 2.6 per cent; log rank = 0.973), while distant recurrence rates were higher after Ms ± IR and OBCS (Ms ± IR:13.1 per cent, OBCS:7.5 per cent, WLE:3.3 per cent; log rank: p < 0.001).ConclusionOBCS is oncologically safe in patients even when histological results are similar to patients treated with Ms ± IR. |
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| Keywords: | Oncoplastic Therapeutic mammoplasty Recurrence Wide excision Mastectomy OBCS"} {"#name":"keyword" "$":{"id":"kwrd0040"} "$$":[{"#name":"text" "_":"oncoplastic breast conservation surgery WLE"} {"#name":"keyword" "$":{"id":"kwrd0050"} "$$":[{"#name":"text" "_":"wide local excision Ms"} {"#name":"keyword" "$":{"id":"kwrd0060"} "$$":[{"#name":"text" "_":"mastectomy IR"} {"#name":"keyword" "$":{"id":"kwrd0070"} "$$":[{"#name":"text" "_":"immediate reconstruction |
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