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

01-10-2016 | Breast Oncology

Outcomes After Oncoplastic Breast-Conserving Surgery in Breast Cancer Patients: A Systematic Literature Review

Authors: Lucy De La Cruz, MD, Stephanie A. Blankenship, MD, MPH, MS, Abhishek Chatterjee, MD, Rula Geha, MD, Nadia Nocera, MD, Brian J. Czerniecki, MD, PhD, Julia Tchou, MD, PhD, Carla S. Fisher, MD

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

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Abstract

Background

Surgeons have increasingly performed breast-conserving surgery (BCS) utilizing oncoplastic techniques in place of standard lumpectomy for early-stage breast cancer. We assess oncologic outcomes after oncoplastic BCS for T1–T2 breast cancer.

Methods

A systematic literature review identified peer-reviewed articles in PubMed evaluating BCS with oncoplastic reconstruction. Selected studies reported on positive margin rate (PMR), re-excision rate (RR), conversion to mastectomy rate (CMR), overall survival (OS), disease-free survival (DFS), local recurrence (LR), distant recurrence (DR), complication rate, and/or cosmetic outcomes.

Results

The search yielded 474 articles; 55 met the inclusion criteria and collectively evaluated 6011 patients with a mean age 54.6 years over a mean follow-up 50.5 months. T1 (43.8 %) and T2 (39.3 %) invasive ductal carcinoma were the most common tumor histopathologies. PMR, RR, and CMR were 10.8, 6.0, and 6.2 %, respectively, while OS, DFS, LR and DR were 95.0, 90.0, 3.2, and 8.7 %, respectively. Margin widths were heterogeneously defined in studies that included margin assessment. The PMR was not significantly different when positive margins were defined as tumor <10, <5, < 2, and <1 mm from ink margin, or tumor on ink (p = 0.162). Eleven studies reported specific margins for 1455 patients, of whom 143 (9.8 %) had positive margins, including 113 (7.8 %) with tumor on ink.

Conclusions

This study is the largest comprehensive literature review to date on oncoplastic BCS. Our systematic review reveals high rates of OS and DFS with low LR, DR, PMR, RR, CMR and complication rates, thereby confirming the oncologic safety of this procedure in patients with T1–T2 invasive breast cancer.
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Metadata
Title
Outcomes After Oncoplastic Breast-Conserving Surgery in Breast Cancer Patients: A Systematic Literature Review
Authors
Lucy De La Cruz, MD
Stephanie A. Blankenship, MD, MPH, MS
Abhishek Chatterjee, MD
Rula Geha, MD
Nadia Nocera, MD
Brian J. Czerniecki, MD, PhD
Julia Tchou, MD, PhD
Carla S. Fisher, 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/s10434-016-5313-1

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