Pushing the Limits of Breast Conserving Surgery with Extreme Oncoplasty


Kilic B., BADEMLER S., İLHAN M. B., Yildirim I., Kucucuk S., Bayram A., ...More

BREAST CARE, 2023 (SCI-Expanded) identifier

  • Publication Type: Article / Article
  • Publication Date: 2023
  • Doi Number: 10.1159/000531533
  • Journal Name: BREAST CARE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE
  • Istanbul University Affiliated: Yes

Abstract

Introduction: We aimed to report the long-term surgical outcomes of extreme oncoplasty techniques in selected patients with unifocal (UF)/ cT3 or multifocal-multicentric tumors (MFMC). Material- Methods: Patients who were initially recommended to have mastectomy had extreme oncoplastic breast conserving surgery (eOBCS) including therapeutic reduction mammoplasty, racquet and round block mammoplasty, Grisotti flap or combined technique were included. Preoperative tumor parameters, clinical outcomes, rate of local recurrence, survival and patients' satisfaction were assessed. Results: Eighty-six patients with a median age of 51 years were followed for a median follow-up of 75 (8- 154) months; 31 (36%) had cT3 and 55 (64%) had MFMC tumor. The majority of patients (83.6%) had invasive cancer. The median UF tumor size was 58 mm (range 51- 100) on imaging and 51 mm (range 50- 60) on final pathology. The median tumor span for MFMC was 65 mm (range 53- 95) on imaging, whereas the median of the largest tumor size was 30 mm (range 22- 60) on final pathology. Seventy-one patients (82.5%) were ER-positive, 17 (19.7%) were HER2 positive, and 8 (9.3%) were TNBC. Four patients (4.7%) required further intervention for having positive margins (3 re-excisions, 1 completion mastectomy). Three local recurrences (3.4%) and 10 (11.6%) distant metastasis occurred. The cosmetic outcome was excellent in 37 (43%) patients. No major complications were observed.Conclusions: eOBCS can be a good option in patients who initially require a mastectomy. Appropriate patient selection, a multidisciplinary approach, and patient consent are essential steps of the procedure.