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

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Acknowledgments

This work was supported in part by the Cancer Center Support Grant (NCI Grant P30 CA016672). We greatly wish to acknowledge Deborah Adair, Helen Zou, and Kelly Merriman, MPH, PhD, for their assistance with data collection for this project.

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Authors and Affiliations

  1. Department of Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Stacey A. Carter MD, Henry M. Kuerer MD, PhD, 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, Kelly K. Hunt MD & Rosa F. Hwang MD

  2. Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Genevieve R. Lyons MSPH & Roland L. Bassett Jr. MS

  3. Center for Reconstructive Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Scott Oates MD, Donald P. Baumann MD, Mark W. Clemens MD & Patrick B. Garvey MD

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  1. Stacey A. Carter MD
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  2. Genevieve R. Lyons MSPH
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Corresponding author

Correspondence to Rosa F. Hwang MD.

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Carter, S.A., Lyons, G.R., Kuerer, H.M. et al. Operative and Oncologic Outcomes in 9861 Patients with Operable Breast Cancer: Single-Institution Analysis of Breast Conservation with Oncoplastic Reconstruction. Ann Surg Oncol 23, 3190–3198 (2016). https://doi.org/10.1245/s10434-016-5407-9

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