Breast-conserving therapy for centrally located breast cancer.
OBJECTIVE
To analyze whether breast-conserving therapy (BCT) may be an oncologically safe approach and result in a good cosmesis in patients with centrally located breast cancer (CLBC).


BACKGROUND
Only underpowered, retrospective, single-arm studies have suggested that oncoplastic BCT for CLBC may be oncologically safe and may result in a good cosmesis.


METHODS
The authors retrospectively analyzed the overall and recurrence-free survival in 1485 patients with breast cancer undergoing BCT comparing CLBC with non-CLBC. Moreover, the authors described 4 different oncoplastic techniques for BCT in patients with CLBC and compared the cosmetic results with simple lumpectomy according to a recently elaborated objective cosmetic evaluation system, the Breast Symmetry Index.


RESULTS
Kaplan-Meier curves show no significant difference in a 5-year overall, local, or distant recurrence-free survival between patients with CLBC and non-CLBC after BCT (94% vs. 96%; 100% vs. 98%; 92% vs. 90%; median follow-up, 35.3 months). The cosmetic outcome after oncoplastic BCT compared with simple lumpectomy differed significantly (Breast Symmetry Index: 22 +/- 6%d vs. 44 +/- 12%d; P < 0.05).


CONCLUSIONS
The results demonstrate that BCT for CLBC is oncologically safe and that oncoplastic techniques improve cosmesis.
Fitzal
Florian
F
Department of Surgery, Medical University of Vienna, Austria. florian.fitzal@meduniwien.ac.at
Mittlboeck
Martina
M
Trischler
Herwig
H
Krois
Wilfried
W
Nehrer
Greta
G
Deutinger
Maria
M
Jakesz
Raimund
R
Gnant
Michael
M
D001943:Breast Neoplasms / Q000401:mortality / Q000601:surgery*; D004954:Esthetics; D005260:Female; D006801:Humans; D015412:Mastectomy, Segmental; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome