Oncoplastic Surgery for Breast-Conserving Surgery: A Single Institution Experience

INDRODUCTION: Breast-conserving surgery is the treatment of choice for early breast cancer and is increasingly being used for larger tumors. A conflict exists between performing a resection wide enough to obtain optimal oncological control and not removing so much breast tissue as to leave a deformed breast. Oncoplastic surgery (OS) improves oncological safety and yields better esthetic results in such cases. The aim of this study is to access oncologic and cosmetic outcomes for patients who underwent OS (lumpectomy with mammoplasty). MATERIAL AND METHODS: Between June 2009 and July 2012, OS was proposed for 41 patients at Fortaleza General Hospital (HGF). Standart treatment protocols were followed. The technique’s choice depends of the tumor’s location and the excision volume. All of the oncoplastic procedures begin with the preoperative marking of the patient sitting in the upright position. Patient’s data were collected from the hospital records and analyzed retrospectively. RESULTS: of the 41 patients scheduled to OS, there were 35 cases of invasive ductal carcinoma (IDC), 2 Invasive lobular carcinoma (ILC), 2 in situ ductal carcinoma (DCIS), 1 paget disease and 1 phyllodes tumor. Assessment of excision margins showed complete excision in 38 patients (92,7%) and 3 patients (7,3%) had involved margins and proceeded to mastectomy. There were early complications in 5 patients. of these, one patient required a reoperation, 2 patients had a delay to adjuvant treatment and one patient had an abscess. All patients but one were sent to radiotherapy. 3 patients had distant metastasis, but no signs of local recurrence after short follow-up. One case had a local recurrence after one year and mastectomy was performed. Cosmetic outcomes were favorable in all patients, but one. DISCUSSION AND CONCLUSIONS: Our study shows that this approach is feasible and can be done without modification to standart treatment procedure. In our series, we had success rate of 92,7 % of the scheduled surgeries. Local recurrence was observed in one patient (2,63%). It shows that it is a safe approach and cosmetic outcomes are favorable, despite wide excisions.