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Short term safety of oncoplastic breast conserving surgery for larger tumors.
Eur J Surg Oncol 2017; 43(4):665-671EJ

Abstract

BACKGROUND

Oncoplastic surgery (OPS) replaces lumpectomy as standard technique in breast conserving surgery (BCS). OPS has shown to give good cosmetic results, but is it as safe as standard lumpectomy? We conducted a retrospective cohort study to determine postoperative complications, resection margins and re-excision rates for OPS compared to standard lumpectomy.

METHODS

Based on data from the 'Netherlands Cancer Registry' and medical records we scored patient, treatment and follow-up related variables. All consecutive patients, with an initially breast conserving operation for primary breast cancer, performed between January 2010 and December 2014 in a dedicated breast center were eligible. Breast surgeons performed the operations. Invasive and in situ tumors were included. Postoperative complications within 30 days after surgery and the need for additional treatment were classified using the Clavien Dindo classification. Involved margin rates and subsequent re-excision were compared.

RESULTS

We included 828 women with 842 breast cancers, who had a standard lumpectomy (62.7%) or oncoplastic resection (37.3%). OPS was performed more often for larger tumors (17.5 mm vs 13.6 mm, p = 0.002) and for tumors in the caudal half of the breast (33.1% vs 16.9%, p < 0.001). There was no significant difference in postoperative complications. Positive surgical margins were similar (OPS 22.6%, lumpectomy 18.2%, p = 0.119), as were re-excision rates (p = 0.337).

CONCLUSION

Oncoplastic breast surgery can be safely applied in larger tumors, resulting in comparable postoperative complications, resection margins and re-excision rates compared to standard lumpectomy.

Authors+Show Affiliations

Department of Surgical Oncology, B58, Canisius Wilhelmina Ziekenhuis, Weg door Jonkerbos 100, 6532 SB Nijmegen, The Netherlands. Electronic address: janneke.wijgman@gmail.com.Department of Surgery, Radboud University Medical Center, Postbus 9101 (618), 6500 HB Nijmegen, The Netherlands. Electronic address: Britt_tenWolde@hotmail.com.Department of Surgical Oncology, B58, Canisius Wilhelmina Ziekenhuis, Weg door Jonkerbos 100, 6532 SB Nijmegen, The Netherlands. Electronic address: nravangroesen@gmail.com.Department of Surgical Oncology, B58, Canisius Wilhelmina Ziekenhuis, Weg door Jonkerbos 100, 6532 SB Nijmegen, The Netherlands. Electronic address: m.keemers@cwz.nl.Department of Surgical Oncology, B58, Canisius Wilhelmina Ziekenhuis, Weg door Jonkerbos 100, 6532 SB Nijmegen, The Netherlands. Electronic address: f.v.d.wildenberg@cwz.nl.Department of Surgical Oncology, B58, Canisius Wilhelmina Ziekenhuis, Weg door Jonkerbos 100, 6532 SB Nijmegen, The Netherlands. Electronic address: ljastrobbe@cwz.nl.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

28041648

Citation

Wijgman, D J., et al. "Short Term Safety of Oncoplastic Breast Conserving Surgery for Larger Tumors." European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, vol. 43, no. 4, 2017, pp. 665-671.
Wijgman DJ, Ten Wolde B, van Groesen NR, et al. Short term safety of oncoplastic breast conserving surgery for larger tumors. Eur J Surg Oncol. 2017;43(4):665-671.
Wijgman, D. J., Ten Wolde, B., van Groesen, N. R., Keemers-Gels, M. E., van den Wildenberg, F. J., & Strobbe, L. J. (2017). Short term safety of oncoplastic breast conserving surgery for larger tumors. European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology, 43(4), pp. 665-671. doi:10.1016/j.ejso.2016.11.021.
Wijgman DJ, et al. Short Term Safety of Oncoplastic Breast Conserving Surgery for Larger Tumors. Eur J Surg Oncol. 2017;43(4):665-671. PubMed PMID: 28041648.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Short term safety of oncoplastic breast conserving surgery for larger tumors. AU - Wijgman,D J, AU - Ten Wolde,B, AU - van Groesen,N R A, AU - Keemers-Gels,M E, AU - van den Wildenberg,F J H, AU - Strobbe,L J A, Y1 - 2016/12/18/ PY - 2016/06/29/received PY - 2016/11/17/revised PY - 2016/11/30/accepted PY - 2017/1/4/pubmed PY - 2017/4/18/medline PY - 2017/1/3/entrez KW - Breast-conserving surgery KW - Oncoplastic surgery KW - Postoperative complications KW - Reoperation KW - Surgical margins SP - 665 EP - 671 JF - European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology JO - Eur J Surg Oncol VL - 43 IS - 4 N2 - BACKGROUND: Oncoplastic surgery (OPS) replaces lumpectomy as standard technique in breast conserving surgery (BCS). OPS has shown to give good cosmetic results, but is it as safe as standard lumpectomy? We conducted a retrospective cohort study to determine postoperative complications, resection margins and re-excision rates for OPS compared to standard lumpectomy. METHODS: Based on data from the 'Netherlands Cancer Registry' and medical records we scored patient, treatment and follow-up related variables. All consecutive patients, with an initially breast conserving operation for primary breast cancer, performed between January 2010 and December 2014 in a dedicated breast center were eligible. Breast surgeons performed the operations. Invasive and in situ tumors were included. Postoperative complications within 30 days after surgery and the need for additional treatment were classified using the Clavien Dindo classification. Involved margin rates and subsequent re-excision were compared. RESULTS: We included 828 women with 842 breast cancers, who had a standard lumpectomy (62.7%) or oncoplastic resection (37.3%). OPS was performed more often for larger tumors (17.5 mm vs 13.6 mm, p = 0.002) and for tumors in the caudal half of the breast (33.1% vs 16.9%, p < 0.001). There was no significant difference in postoperative complications. Positive surgical margins were similar (OPS 22.6%, lumpectomy 18.2%, p = 0.119), as were re-excision rates (p = 0.337). CONCLUSION: Oncoplastic breast surgery can be safely applied in larger tumors, resulting in comparable postoperative complications, resection margins and re-excision rates compared to standard lumpectomy. SN - 1532-2157 UR - https://www.unboundmedicine.com/medline/citation/28041648/Short_term_safety_of_oncoplastic_breast_conserving_surgery_for_larger_tumors_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0748-7983(16)31050-2 DB - PRIME DP - Unbound Medicine ER -