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Oberhauser I, Zeindler J, Ritter M, Levy J, Montagna G, Mechera R, Soysal SD, Castrezana López L, D'Amico V, Kappos EA, Schwab FD, Müller M, Kurzeder C, Haug M, Weber WP. Impact of Oncoplastic Breast Surgery on Rate of Complications, Time to Adjuvant Treatment, and Risk of Recurrence. Breast Care (Basel) 2021; 16:452-460. [PMID: 34720804 DOI: 10.1159/000511728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/01/2020] [Indexed: 11/19/2022] Open
Abstract
Background The aim of this study was to compare the risk of complications and recurrence between oncoplastic and conventional breast surgery. Methods This is a retrospective analysis of a consecutive series of 436 patients with stage I-III breast cancer who underwent surgery at the University Hospital of Basel between 2011 and 2018. Results The nipple/skin-sparing mastectomy (NSM/SSM) group showed significantly more delayed wound healing (32.7 vs. 5.8%, p < 0.001) and skin necrosis (13.9 vs. 1.9%, p = 0.020) compared to conventional mastectomy (CM), which corresponded to significantly higher odds of short-term complications (OR 2.34, 95% CI 1.02-5.35, p = 0.044). The incidence rate of long-term morbidity in oncoplastic breast-conserving surgery (OBCS) was significantly higher compared to conventional breast-conserving surgery (CBCS; 25.5 vs. 11.3 per 100 patient years [PY], p < 0.001), in particular concerning chronic pain (13.3 vs. 6.6, p = 0.011) and lymphedema (4.1 vs. 0.4, p = 0.003). Seroma as a long-term morbidity occurred more often in the CM group compared to the NSM/SSM group (5.8 vs. 0.5 per 100 PY, p = 0.004). Patients received adjuvant treatment earlier after CM compared to NSM/SSM (HR 1.83, 95% CI 1.05-3.19, p = 0.034). There were no significant differences in the incidence of positive margins nor in the odds of recurrence after OBCS versus CBCS and after NSM/SSM versus CM. Conclusions Even though the present study confirmed expected differences in complications and morbidity, it suggested that oncoplastic surgery is oncologically safe. Patients undergoing NSM/SSM should be followed closely to allow early detection and treatment of frequently associated complications and ensure timely start of adjuvant therapy.
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Affiliation(s)
- Ida Oberhauser
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Breast Surgery, University Hospital of Basel, Basel, Switzerland
| | - Jasmin Zeindler
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Breast Surgery, University Hospital of Basel, Basel, Switzerland
| | - Mathilde Ritter
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Breast Surgery, University Hospital of Basel, Basel, Switzerland
| | - Jeremy Levy
- Biometrical Practice BIOP, Basel, Switzerland
| | - Giacomo Montagna
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland
| | - Robert Mechera
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Breast Surgery, University Hospital of Basel, Basel, Switzerland
| | - Savas Deniz Soysal
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Breast Surgery, University Hospital of Basel, Basel, Switzerland
| | - Liliana Castrezana López
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Breast Surgery, University Hospital of Basel, Basel, Switzerland
| | - Veronica D'Amico
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Breast Surgery, University Hospital of Basel, Basel, Switzerland
| | - Elisabeth Artemis Kappos
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland
| | - Fabienne Dominique Schwab
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland
| | - Madleina Müller
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland
| | - Christian Kurzeder
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Obstetrics and Gynecology, University Hospital of Basel, Basel, Switzerland
| | - Martin Haug
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Plastic, Reconstructive, Aesthetic and Hand Surgery, University Hospital of Basel, Basel, Switzerland
| | - Walter Paul Weber
- Breast Center, University Hospital of Basel, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Department of Breast Surgery, University Hospital of Basel, Basel, Switzerland
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