Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer.
BACKGROUND
Oncoplastic surgery for breast cancer is a novel concept that combines a plastic surgical procedure with breast-conserving treatment to improve the final cosmetic results. The aim of this study was to evaluate the oncological safety of oncoplastic procedures by studying the status of the surgical margins of the excised tumor specimen in comparison with standard quadrantectomies.


METHODS
Thirty consecutive breast cancer patients undergoing oncoplastic surgery (group 1) and 30 patients undergoing standard quadrantectomy (group 2) were prospectively studied with regard to the stage of breast cancer, the surgical procedures performed, the volume of breast tissue excised, and the histopathology of the tumor specimen, with specific details on surgical margins.


RESULTS
Patients who underwent oncoplastic surgery (group 1) were younger (mean age, 48.73 years) than patients who had a classic quadrantectomy (group 2; mean age, 55.76 years; P = .022). The mean volume of the excised specimen in group 1 was 200.18 cm(3), compared with 117.55 cm(3) in group 2 (P = .016). Surgical margins were negative in 25 cases out of 30 in group 1 and 17 out of 30 in group 2 (P = .05). The average length of the surgical margin was 8.5 mm in group 1 and 6.5 mm in group 2, but the difference was not statistically significant (P = .074).


CONCLUSIONS
Oncoplastic surgery adds to the oncological safety of breast-conserving treatment because a larger volume of breast tissue can be excised and a wider negative margin can be obtained. It is especially indicated for large tumors, for which standard breast-conserving treatment has a high probability of leaving positive margins.
Kaur
Navneet
N
Department of Plastic and Reconstructive Surgery, European Institute of Oncology, Via Ripamonti, 435, 20141 Milan, Italy. jean.petit@ieo.it
Petit
Jean-Yves
JY
Rietjens
Mario
M
Maffini
Fausto
F
Luini
Alberto
A
Gatti
Giovanna
G
Rey
Pier Carlo
PC
Urban
Cicero
C
De Lorenzi
Francesca
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental / Q000379:methods*; D008875:Middle Aged; D019651:Plastic Surgery Procedures; D012189:Retrospective Studies; D016896:Treatment Outcome