title: Evaluation of Surgical Outcomes of Oncoplasty Breast Surgery in Locally Advanced Breast Cancer and Comparison with Conventional Breast Conservation Surgery.
abstract: The purpose of this study was to compare early oncologic outcomes of oncoplastic breast surgery and conventional breast conservation surgery in patients of locally advanced breast cancer. A single-center, prospective, non-randomized study enrolled select cases of locally advanced breast cancer (TNM T3/T4, N0/1/2) who after neoadjuvant chemotherapy, were considered for breast conservation surgery with oncoplasty techniques. The specimen volume resected, the mean margins and mean closest margin obtained were noted. The re-surgery rates, complication rates, and incidence of locoregional recurrence were also noted. Variables were compared with a retrospective cohort of similar patients who had undergone conventional breast conservation surgery. Fifty-seven patients underwent OBS (group 1) and were compared with 43 cases that had undergone conventional BCS (group 2). Majority of the patients in group 1 (73 %) had cT3 with N0 or N+ and a minority (17 %) were with limited skin involvement (cT4 and N0/N+). Relatively larger sized, post-NACT tumors could undergo OBS(4.4 vs 2.3 cm). Relatively greater proportion of tumors in central and lower quadrants were addressed by oncoplasty than traditional BCS (17/57, 29 % vs 4/43, 9 %,p= 0.04). The mean specimen volume excised in group 1 was more than that in group 2. (187.54 vs 125.19;p= 0.01). The mean of the margins were obtained more in group 1 (1.04 vs 0.69 cm);p< 0.01) as also the mean closest margin (0.86 vs 0.49 cm;p< 0.01). The incidence of close or involved margins was lesser in the OBS group (8 vs 24 %). Overall incidence of complications was similar in both groups (8/57, 14 % vs 4/43, 9 %;p= 0.34 NS). The median follow-up period of group 1 is 18 months (range 06-30 months) while group 2 is 34 months (14-44 months. There was no recurrence in group 1, but there were 5 cases (11 %) in group 2. Oncoplasty breast surgery offers more opportunity for breast conservation and oncologic safety than conventional breast conserving surgery.
authors.affiliation: Department of Surgery, Command Hospital(CC), Lucknow, India.
authors.forename: Ashutosh
authors.initials: A
authors.lastname: Chauhan
authors.affiliation: Department of Surgery, Command Hospital(CC), Lucknow, India.
authors.forename: Mala Mathur
authors.initials: MM
authors.lastname: Sharma
authors.affiliation: Department of Medicine, Command Hospital(CC), Lucknow, India.
authors.forename: Kishore
authors.initials: K
authors.lastname: Kumar
keywords: Breast cancer; Breast conservation; Early outcomes; Oncoplasty