| Abstrakt: |
Background: Oncoplastic reduction mammoplasty (ORM) allows greater margins without compromising breast shape in comparison to breast conserving therapy (BCT). However, the long-term influence of this treatment on cancer recurrence remains unclear. Methods: The benefits of ORM in comparison to BCT were reviewed by conducting a retrospective review of 215 patients. Data on patient demographics, comorbidities, cancer histology, tumour size, receptor status, neoadjuvant or adjuvant therapies, surgical intervention duration, width of the microscopic and macroscopic narrowest margins, need for surgical re-excision or completion of mastectomy, morbidity, duration of hospital stay, recurrence, and mortality rate were gathered and analysed. Results: Two hundred fifteen patients with breast cancer were analysed: 58.1% underwent BCT and 41.8% underwent ORM. The median follow-up was 89.8 months. Immediate margin enlargement due to the margins being considered insufficient was performed in 58.6% of the patients in BCT group and 53.3% of those who underwent ORM. Margins of the initial breast specimen were reported as intersected in 25.6% of the BCT group and 9.2% of the ORM group. Margins were larger in the ORM (median 4.0 mm) than in the BCT group (median 2.0 mm). The number of mastectomies performed after breast sparing surgery was higher in the BCT (17.5%) than in the ORM group (5.6%). A delay of 22.5 days to the end of radiotherapy was found in the ORM group but was not statistically significant. The local and/or distant recurrence-free survival rates during the follow-up period did not differ, which were 96.0% and 94.4% in the BCT and ORM groups, respectively. Likewise, the cancer-specific survival rates were 96.8% and 96.7%, respectively. Conclusions: Despite a delay in the completion of radiotherapy, OMR offers wider margins, lower rates of positive margins, and lower rates of re-excision/mastectomy. No difference was found in the local and/or distant recurrence-free survival or breast cancer-specific survival. Level of evidence: Level III, therapeutic study. [ABSTRACT FROM AUTHOR] |
Full text from SpringerLink