title: Oncological results of oncoplastic breast-conserving surgery: Long term follow-up of a large series at a single institution: A matched-cohort analysis.
abstract: OBJECTIVE
  Oncoplastic surgery is a well-established discipline that combines conserving treatment for breast cancer with immediate plastic reconstruction. Although widely practiced, the oncologic outcomes of this combined approach are reported only in small series. The aim of the present paper is to assess the safety of oncoplastic surgery for invasive primary breast cancer.
  
  
  METHODS
  We compared 454 consecutive patients who underwent an oncoplastic approach between 2000 and 2008 for primary invasive breast tumors (study group) with twice the number of patients who received conservation alone in the same interval time (control group). Disease free survival and overall survival were estimated using the Kaplan-Meier method. The log-rank test was used to assess differences between groups.
  
  
  RESULTS
  The median follow-up was 7.2 years. The overall survival is similar within the two groups, being 91.4% and 91.3% at 10-yr in the study group and in the control group respectively. The disease free survival is slightly lower in the oncoplastic group (69 vs.73.1% at 10-yr). The difference is not statistically significant.
  
  
  CONCLUSIONS
  We have compared a large series of primary breast cancer patients that have undergone oncoplastic surgery (454) with a control group (908) and they were followed for a prolonged period of time. It provides the best available evidence to suggest that oncoplastic surgery is a safe and reliable treatment option for the managing of invasive breast cancer.
authors.affiliation: Division of Reconstructive Surgery, European Institute of Oncology, Via Ripamonti 435, Milan, Italy. Electronic address: francesca.delorenzi@ieo.it.
authors.forename: F
authors.initials: F
authors.lastname: De Lorenzi
authors.affiliation: Division of Reconstructive Surgery, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Hubner
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: N
authors.initials: N
authors.lastname: Rotmensz
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy; Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Bagnardi
authors.affiliation: Division of Reconstructive Surgery, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Loschi
authors.affiliation: Division of Epidemiology and Biostatistics, European Institute of Oncology, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Maisonneuve
authors.affiliation: Division of Anesthesia, European Institute of Oncology, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Venturino
authors.affiliation: Division of Radiotherapy, European Institute of Oncology, Milan, Italy; University of Milan, Milan, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Orecchia
authors.affiliation: Division of Surgical Senology, European Institute of Oncology, Milan, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Galimberti
authors.affiliation: Division of Surgical Senology, European Institute of Oncology, Milan, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Veronesi
authors.affiliation: Division of Reconstructive Surgery, European Institute of Oncology, Via Ripamonti 435, Milan, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Rietjens
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016022:Case-Control Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D016462:Mammaplasty / Q000379:methods* / Q000401:mortality*; D015412:Mastectomy, Segmental / Q000379:methods* / Q000401:mortality; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000469:parasitology* / Q000601:surgery; D009367:Neoplasm Staging; D061214:Patient Safety; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D018709:Statistics, Nonparametric; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome
keywords: Conservative treatment; Invasive breast cancer; Local recurrence; Oncoplastic surgery