Oncological and Cosmetic outcome of Oncoplastic breast surgery.

Abstract

Objectives: Oncoplastic breast surgery (OBS) is a revolutionary approach for managing breast cancer. This manuscript aimed to assess the oncological and cosmetic outcomes of OBS in breast cancer. Study Design: Descriptive, prospective study. Setting: Department of Surgery, Madina Teaching Hospital, Faisalabad. Period: January 2018 to June 2019. Material & Methods: Females with invasive breast cancer having 5-6 cm tumour size, Locally advanced tumour after chemotherapy, single tumour and patients < 70 years were included; while patients with fixed tumours, high tumour to breast size ratio, multiple axillary lymph nodes, metastatic cancer & patient’s choice for mastectomy were excluded. Oncological outcome was assessed by; Margin involvement, time lag for chemotherapy, local recurrence and distant metastasis. Cosmetic outcome was detected by score given by patient and an independent surgeon. Results: Thirty two female patients underwent OBS. Mean age of patients was 46.56 yr (SD =10.23). Six patients (18.8%) had central tumors. 3 patients were post neoadjuvant chemotherapy. In 28 patients volume displacement (VD) surgery; while in 4 patients volume replacement (VR) using different flaps like LICAP flap were done. Oncological outcome showed positive margin in one case only, in all other cases clear margins were found. Chemotherapy start time varied from 3 to 8 weeks after surgery (Mean=31.3 days). Delayed time was associated with high BMI and diabetes (P<0.05). Local recurrence or distant metastasis was not noticed in any case. Majority of the patients and surgeon (90%) were satisfied with cosmetic outcome. Conclusion: Oncoplastic Breast surgery is a unique approach to conserve breast even in larger tumours without compromise on oncological principles and cosmesis.