title: Operative and Oncologic Outcomes in 9861 Patients with Operable Breast Cancer: Single-Institution Analysis of Breast Conservation with Oncoplastic Reconstruction.
abstract: Oncoplastic reconstruction is an approach that enables patients with locally advanced or adversely located tumors to undergo breast conserving surgery (BCS). The objectives were to identify the use of BCS with oncoplastic reconstruction (BCS + R) and determine the operative and oncologic outcomes compared with other breast surgical procedures for breast cancer.
  
  
  
  This retrospective cohort study interrogated a single institution's prospectively maintained databases to identify patients who underwent surgery for breast cancer between 2007 and 2014. Surgeries were categorized as BCS, BCS + R, total mastectomy (TM), or TM with immediate reconstruction (TM + R). Demographic and clinicopathologic characteristics and postoperative complications were analyzed.
  
  
  
  There were 10,607 operations performed for 9861 patients. Median follow-up was 3.4 years (range, 0-9.1 years). The use of BCS + R had a nearly fourfold increase in the percentage of all breast cancer surgeries during the study period; 75 % of patients who underwent BCS + R had a T1 or T2 tumor. There was no difference in the use of BCS + R compared with BCS for any quadrant of the breast except the lower outer quadrant (11.1 vs. 6.8 %; p < .0001). BCS + R had a lower rate of seroma formation (13.4 vs. 18 %; p = .002) and positive or close margins compared with BCS (5.8 vs. 8.3 %; p = .04). There was no difference in overall survival or recurrence-free survival when comparing BCS and BCS + R.
  
  
  
  Patients undergoing BCS + R are not disadvantaged in terms of complications and short-term (3-year) outcomes compared with BCS patients or patients who underwent TM.
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Carter
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Genevieve R
authors.initials: GR
authors.lastname: Lyons
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Henry M
authors.initials: HM
authors.lastname: Kuerer
authors.affiliation: Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Roland L
authors.initials: RL
authors.lastname: Bassett
authors.affiliation: Center for Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Scott
authors.initials: S
authors.lastname: Oates
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Alastair
authors.initials: A
authors.lastname: Thompson
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Abigail S
authors.initials: AS
authors.lastname: Caudle
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Mittendorf
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Bedrosian
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Anthony
authors.initials: A
authors.lastname: Lucci
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: DeSnyder
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Gildy
authors.initials: G
authors.lastname: Babiera
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Min
authors.initials: M
authors.lastname: Yi
authors.affiliation: Center for Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Donald P
authors.initials: DP
authors.lastname: Baumann
authors.affiliation: Center for Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Mark W
authors.initials: MW
authors.lastname: Clemens
authors.affiliation: Center for Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Patrick B
authors.initials: PB
authors.lastname: Garvey
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Hunt
authors.affiliation: Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA. rhwang@mdanderson.org.
authors.forename: Rosa F
authors.initials: RF
authors.lastname: Hwang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000473:pathology* / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016462:Mammaplasty / Q000009:adverse effects / Q000639:trends; D000072662:Margins of Excision; D015412:Mastectomy, Segmental / Q000009:adverse effects / Q000639:trends; D015413:Mastectomy, Simple / Q000009:adverse effects; D008875:Middle Aged; D009367:Neoplasm Staging; D018365:Neoplasm, Residual; D012189:Retrospective Studies; D049291:Seroma / Q000209:etiology; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult