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Evaluation of Surgical Outcomes of Oncoplasty Breast Surgery in Locally Advanced Breast Cancer and Comparison with Conventional Breast Conservation Surgery

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Abstract

The purpose of this study was to compare early oncologic outcomes of oncoplastic breast surgery and conventional breast conservation surgery in patients of locally advanced breast cancer. A single-center, prospective, non-randomized study enrolled select cases of locally advanced breast cancer (TNM T3/T4, N0/1/2) who after neoadjuvant chemotherapy, were considered for breast conservation surgery with oncoplasty techniques. The specimen volume resected, the mean margins and mean closest margin obtained were noted. The re-surgery rates, complication rates, and incidence of locoregional recurrence were also noted. Variables were compared with a retrospective cohort of similar patients who had undergone conventional breast conservation surgery. Fifty-seven patients underwent OBS (group 1) and were compared with 43 cases that had undergone conventional BCS (group 2). Majority of the patients in group 1 (73 %) had cT3 with N0 or N+ and a minority (17 %) were with limited skin involvement (cT4 and N0/N+). Relatively larger sized, post-NACT tumors could undergo OBS(4.4 vs 2.3 cm). Relatively greater proportion of tumors in central and lower quadrants were addressed by oncoplasty than traditional BCS (17/57, 29 % vs 4/43, 9 %, p = 0.04). The mean specimen volume excised in group 1 was more than that in group 2. (187.54 vs 125.19; p = 0.01). The mean of the margins were obtained more in group 1 (1.04 vs 0.69 cm); p < 0.01) as also the mean closest margin (0.86 vs 0.49 cm; p < 0.01). The incidence of close or involved margins was lesser in the OBS group (8 vs 24 %). Overall incidence of complications was similar in both groups (8/57, 14 % vs 4/43, 9 %; p = 0.34 NS). The median follow-up period of group 1 is 18 months (range 06–30 months) while group 2 is 34 months (14–44 months. There was no recurrence in group 1, but there were 5 cases (11 %) in group 2. Oncoplasty breast surgery offers more opportunity for breast conservation and oncologic safety than conventional breast conserving surgery.

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References

  1. Fisher B, Anderson S, Bryant J, et al. (2002) Twenty-year follow-up of a randomized trial comparing total mastectomy, lumpectomy, and lumpectomy plus irradiation for the treatment of invasive breast cancer. N Engl J Med 347:1233–1241

    Article  PubMed  Google Scholar 

  2. Parmar V, Hawaldar R, Badwe RA (2010) Safety of partial breast reconstruction in extended indications for conservative surgery in breast cancer. Indian J Surg Oncol 1:256–262

    Article  PubMed  Google Scholar 

  3. Chen AM, Meric-Bernstam F, Hunt KK, et al. (2004) Breast conservation after neoadjuvant chemotherapy: the MD Anderson cancer center experience. J Clin Oncol 22:2303–2312

    Article  PubMed  Google Scholar 

  4. Parmar V, Krishnamurthy A, Hawaldar R, et al. (2006) Breast conservation treatment in women with locally advanced breast cancer—experience from a single centre. Int J Surg 4:106–114

    Article  CAS  PubMed  Google Scholar 

  5. Sinacki M, Jassem J, van Tienhoven G (2005) Conservative local treatment versus mastectomy after induction chemotherapy in locally advanced breast cancer: a randomised phase III study (EORTC 10974/22002, LAMANOMA)—why did this study fail? Eur J Cancer 41:2787–2788

    Article  PubMed  Google Scholar 

  6. Clough KB, Lewis JS, Couturaud B, et al. (2003) Oncoplastic techniques allow extensive resections for breast conserving therapy of breast carcinomas. Ann Surg 237:26–34

    Article  PubMed  PubMed Central  Google Scholar 

  7. Kaur N, Petit JY, Rietjens M, et al. (2005) Comparative study of surgical margins in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol 12:539–545

    Article  PubMed  Google Scholar 

  8. Giacalone PL, Roger P, Dubon O, et al. (2006) Comparative study of the accuracy of breast resection in oncoplastic surgery and quadrantectomy in breast cancer. Ann Surg Oncol 14:605–614

    Article  PubMed  Google Scholar 

  9. Rustogi A, Budrukkar A, Dinshaw K, Jalali R (2005) Management of locally advanced breast cancer: evolution and current practice. J Cancer Res Ther 1:21–27

    Article  PubMed  Google Scholar 

  10. Akhtar M, Akulwar V, Gandhi D, Chandak K (2011) Is locally advanced breast cancer a neglected disease? Indian J Cancer 48:403–405

    Article  CAS  PubMed  Google Scholar 

  11. Cance WG, Carey LA, Calvo BF, et al. (2002) Long-term outcome of neoadjuvant therapy for locally advanced breast carcinoma: effective clinical down staging allows breast preservation and predicts outstanding local control and survival. Ann Surg 236:295–302

    Article  PubMed  PubMed Central  Google Scholar 

  12. Wolmark N, Wang J, Mamounas E, et al. (2001) Preoperative chemotherapy in patients with operable breast cancer: nine-year results from National Surgical Adjuvant Breast and Bowel Project B-18. J Natl Cancer Inst Monogr 30:96–102

    Article  Google Scholar 

  13. Hortobagyi GN, Singletary SE, Strom EA (eds) (2010) Locally advanced breast cancer. Diseases of the breast, 4 edn. Lippincott Williams and Wilkins, Philadelphia, pp. 750–751

    Google Scholar 

  14. Mathieu MC, Bonhomme-Faivre L, Rouzier R, Seiller M, Barreau-Pouhaer L, Travagli JP (2007) Tattooing breast cancers treated with neoadjuvant chemotherapy. Ann Surg Oncol 14:2233–2238

    Article  PubMed  Google Scholar 

  15. Bonadonna G, Valagussa P, Brambilla C, et al. (1998) Primary chemotherapy in operable breast cancer: eight year experience at the Milan cancer institute. J Clin Oncol 16:93–100

    CAS  PubMed  Google Scholar 

  16. Singletary SE, McNeese MD, Hortobagyi GN (1992) Feasibility of breast-conservation surgery after induction chemotherapy for locally advanced breast carcinoma. Cancer 69:2849–2852

    Article  CAS  PubMed  Google Scholar 

  17. Abraham DC, Jones RC, Jones SE, et al. (1996) Evaluation of neoadjuvant chemotherapeutic response of locally advanced breast cancer by magnetic resonance imaging. Cancer 78:91–100

    Article  CAS  PubMed  Google Scholar 

  18. Gentilini O, Intra M, Gandini S, et al. (2006) Ipsilateral breast tumor reappearance in patients treated with conservative surgery after primary chemotherapy. The role of surgical margins on outcome. J Surg Oncol 94:375–379

    Article  PubMed  Google Scholar 

  19. Mazouni C, Naveau A, Kane A, et al. (2013) The role of oncoplastic breast surgery in the management of breast cancer treated with primary chemotherapy. Breast 13:1189–1193

    Article  Google Scholar 

  20. Zucca Matthes AG, Uemura G, Kerr L, et al. (2012) Feasibility of oncoplastic techniques in the surgical management of locally advanced breast cancer. Int J Surg 10:500–505

    Article  PubMed  Google Scholar 

  21. Bogusevicius A, Cepuliene D, Sepetauskiene E (2014) The integrated evaluation of the results of oncoplastic surgery for locally advanced breast cancer. Breast J 20:53–60

    Article  PubMed  Google Scholar 

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Acknowledgment

Ms. Harleen Chabbra, Translational Psychiatry Lab, NIMHANS, Bangalore for statistics support.

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Authors and Affiliations

  1. Department of Surgery, Command Hospital(CC), Lucknow, India

    Ashutosh Chauhan & Mala Mathur Sharma

  2. Department of Medicine, Command Hospital(CC), Lucknow, India

    Kishore Kumar

Authors
  1. Ashutosh Chauhan
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  2. Mala Mathur Sharma
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  3. Kishore Kumar
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Corresponding author

Correspondence to Ashutosh Chauhan.

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The study was approved by the Institutional Committee of Research Ethics. Written informed consent was obtained from all patients.

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The authors declare that they have no conflict of interest.

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Chauhan, A., Sharma, M.M. & Kumar, K. Evaluation of Surgical Outcomes of Oncoplasty Breast Surgery in Locally Advanced Breast Cancer and Comparison with Conventional Breast Conservation Surgery. Indian J Surg Oncol 7, 413–419 (2016). https://doi.org/10.1007/s13193-016-0549-6

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  • DOI: https://doi.org/10.1007/s13193-016-0549-6

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