Oncoplastic Surgery Versus Lumpectomy: Analysis of Oncological Outcomes and Surgical Complications in 1290 Breast Cancer Patients

TL;DR

A study of 1290 breast cancer patients found that oncoplastic surgery is as safe as standard lumpectomy for cancer control, despite minor cosmetic and timing differences.

Contribution

The study provides evidence that oncoplastic surgery maintains equivalent cancer outcomes while improving aesthetics.

Findings

Oncoplastic surgery had equivalent cancer control and survival outcomes compared to standard lumpectomy.

Oncoplastic surgery was associated with minor complications like wound infection and fat necrosis.

There was a slight delay in starting radiotherapy with oncoplastic surgery.

Abstract

Oncoplastic breast-conserving surgery allows women with breast cancer to keep more of their breast while still removing the cancer safely. Although some patients worry that this approach may delay follow-up treatments or raise the risk of recurrence, this large long-term study found that while oncoplastic surgery caused slightly more minor wound issues and a small delay in starting radiotherapy, cancer control and survival outcomes were the same as with standard lumpectomy. These results suggest that the oncoplastic approach is both safe and effective, helping women achieve better cosmetic results without compromising cancer care. The findings could encourage more surgeons and patients to consider oncoplastic surgery as a standard option, guide health systems in planning breast cancer services, and support future research on optimizing outcomes and recovery after breast-conserving surgery.

This 12-year retrospective study compared oncoplastic breast-conserving surgery (OBCS) with lumpectomy without reconstruction (LNR) to evaluate surgical and oncological outcomes. OBCS combines tumour removal with tissue reshaping to preserve breast contour, but concerns about treatment delays and recurrence limit its use. Among 1880 patients reviewed between 2008 and 2020, 1290 met the inclusion criteria—307 (24%) underwent OBCS and 983 (76%) underwent LNR. Women receiving OBCS were younger (mean 56 vs. 61 years, p < 0.0001) with similar BMIs. OBCS was associated with a slightly longer time to radiotherapy (3.93 vs. 3.57 months, p = 0.01) and higher rates of minor complications such as wound infection (7.17% vs. 3.66%), dehiscence (4.89% vs. 0.92%), and fat necrosis (11.73% vs. 1.12%) (all p < 0.0001). There were no significant differences in positive margins, mastectomy conversion, recurrence, or disease-free survival. Despite a modest delay in adjuvant therapy and increased minor complications, OBCS demonstrated equivalent oncologic safety to standard lumpectomy. These findings support OBCS as a safe breast-conserving option that maintains esthetic outcomes without compromising cancer control, encouraging its broader use in appropriately selected patients.

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