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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 10/2016

01-10-2016 | Breast Oncology

Operative and Oncologic Outcomes in 9861 Patients with Operable Breast Cancer: Single-Institution Analysis of Breast Conservation with Oncoplastic Reconstruction

Authors: Stacey A. Carter, MD, Genevieve R. Lyons, MSPH, Henry M. Kuerer, MD, PhD, Roland L. Bassett Jr., MS, Scott Oates, MD, Alastair Thompson, BSc(Hons), MB ChB, MD, Abigail S. Caudle, MD, MS, Elizabeth A. Mittendorf, MD, PhD, Isabelle Bedrosian, MD, Anthony Lucci, MD, Sarah M. DeSnyder, MD, Gildy Babiera, MD, Min Yi, MD, PhD, Donald P. Baumann, MD, Mark W. Clemens, MD, Patrick B. Garvey, MD, Kelly K. Hunt, MD, Rosa F. Hwang, MD

Published in: Annals of Surgical Oncology | Issue 10/2016

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Abstract

Background

Oncoplastic reconstruction is an approach that enables patients with locally advanced or adversely located tumors to undergo breast conserving surgery (BCS). The objectives were to identify the use of BCS with oncoplastic reconstruction (BCS + R) and determine the operative and oncologic outcomes compared with other breast surgical procedures for breast cancer.

Methods

This retrospective cohort study interrogated a single institution’s prospectively maintained databases to identify patients who underwent surgery for breast cancer between 2007 and 2014. Surgeries were categorized as BCS, BCS + R, total mastectomy (TM), or TM with immediate reconstruction (TM + R). Demographic and clinicopathologic characteristics and postoperative complications were analyzed.

Results

There were 10,607 operations performed for 9861 patients. Median follow-up was 3.4 years (range, 0–9.1 years). The use of BCS + R had a nearly fourfold increase in the percentage of all breast cancer surgeries during the study period; 75 % of patients who underwent BCS + R had a T1 or T2 tumor. There was no difference in the use of BCS + R compared with BCS for any quadrant of the breast except the lower outer quadrant (11.1 vs. 6.8 %; p < .0001). BCS + R had a lower rate of seroma formation (13.4 vs. 18 %; p = .002) and positive or close margins compared with BCS (5.8 vs. 8.3 %; p = .04). There was no difference in overall survival or recurrence-free survival when comparing BCS and BCS + R.

Conclusions

Patients undergoing BCS + R are not disadvantaged in terms of complications and short-term (3-year) outcomes compared with BCS patients or patients who underwent TM.
Appendix
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Metadata
Title
Operative and Oncologic Outcomes in 9861 Patients with Operable Breast Cancer: Single-Institution Analysis of Breast Conservation with Oncoplastic Reconstruction
Authors
Stacey A. Carter, MD
Genevieve R. Lyons, MSPH
Henry M. Kuerer, MD, PhD
Roland L. Bassett Jr., MS
Scott Oates, MD
Alastair Thompson, BSc(Hons), MB ChB, MD
Abigail S. Caudle, MD, MS
Elizabeth A. Mittendorf, MD, PhD
Isabelle Bedrosian, MD
Anthony Lucci, MD
Sarah M. DeSnyder, MD
Gildy Babiera, MD
Min Yi, MD, PhD
Donald P. Baumann, MD
Mark W. Clemens, MD
Patrick B. Garvey, MD
Kelly K. Hunt, MD
Rosa F. Hwang, MD
Publication date
01-10-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 10/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5407-9

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