2950-2954-Comparative study of oncoplastic versus non-oncoplastic BCS in a group of 211 breast cancer patients

for most patients with early breast cancer; in fact, this technique has proven to be comparable with mastectomy in terms of long-term survival in selected groups of women1,2. This surgical option consists of lumpectomy and sentinel node biopsy with or without radiotherapy and presents potential advantages over radical procedures as it is less invasive, less debilitating and more aesthetically acceptable3,4. Despite the marked improvement represented by BCS, the aesthetic outcome is often compromised to obtain a complete excision of the cancer5 and poor cosmetic results have been reported in 25-30% of patients6,7. Two of the main factors that impact on the aesthetic result are tumor-to-breast volume and tumor location. A volume excision of 10% is usually considered an aesthetically acceptable limit for BCS; however, due to the relative tissue paucity, medially reduction of more than 5% can lead to bad aesthetic results, whereas it is possible to remove up to the 15% of the breast volume laterally with a positive outcome8. Apart from the aesthetic factor, BCS presents some limitations as it cannot be performed in some specific conditions, such as tumor larger than 5 cm, skin or pectoral muscle involvement, multicentric cancers, anticipated poor cosmetic outcome (for example due to unfavorable tumor-to-breast size ratio), and unsuitable radiation therapy9. In addition, mastectomy is traditionally preferred in patients at higher risk of local recurrence10. Although breast cancer remains the most common cancer among women in the Western population, survival rates have consistently increased over the last decades, mainly thanks to the spreading of screening campaigns, combined with improvements in radiotherapy, hormone therapy and chemotherapy11. In addition, thanks to the availability of neo-adjuvant chemotherapy, many Abstract. – OBJECTIVE: Breast conserving surgery (BCS) followed by radiotherapy is the standard of care for most patients with early breast cancers; however, the aesthetic outcomes of this procedure is not always desirable. Oncoplastic breast surgery is an innovative approach that aims at the safe and effective treatment of the cancerous lesion while achieving the best possible aesthetic outcome. The aim of this study was to evaluate and compare oncoplastic and non-oncoplastic procedures. PATIENTS AND METHODS: A retrospective observational study was conducted on a group of patients who underwent oncoplastic or non-oncoplastic breast surgery at the Breast Unit of the University of Rome Tor Vergata. RESULTS: Out of 211 patients, 154 (73%) underwent non-oncoplastic surgery, while 61 (27%) underwent an oncoplastic procedure. The percentage of patients requiring re-excision was twice greater for women in the non-oncoplastic group: 12.9% vs. 6.5% in the oncoplastic group. The rate of complications was higher in the oncoplastic group compared to the non-oncoplastic one (4.9% vs. 1.3%). The size of the tumor, the number of the patients receiving post-operative radiation, the interval between surgery and radiotherapy and follow-up were similar between the two groups. CONCLUSIONS: Oncoplastic surgery represents a valid alternative to breast conserving surgery for patients with breast cancer, with only minimal differences in long term complications and similar results in terms of local recurrence and number of metastasis.