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A Comparison Between Oncoplastic Breast Conserving Surgery andStandard Wide Local Excision: A UK Experience

Saira Khawaja, Abrar Saiyed, Darmiga Thayabaran, Sujatha Udayasankar, Joel Dias, Anita M Huws, Yousef Sharaiha and Simon DH Holt

Background: The goal of breast conserving surgery is to achieve complete excision of the tumor with adequate surgical margins, while preserving the natural shape and appearance of the breast. This is a retrospective study which compared operative outcomes in oncoplastic (OPS; n=54) versus standard wide local excision (WLE; n=265) populations. A total of 319 consecutive patients were included in the study. The primary outcomes were the size of the tumor, weight of the specimen and margin clearance. The secondary outcomes were patient satisfaction, local recurrence rates and operative time.

Methods: A retrospective comparison of patients undergoing breast conservation from November 2011 to January 2015 was undertaken. This time period was chosen as oncoplastic breast conservation (OPS) was introduced at our breast unit in 2011. The majority of these latter surgeries involved volume displacement methods. Demographic data was collected. Statistical analysis was performed using SPSS software.

Results: Our results demonstrated that OPS excised significantly larger tumors (p<0.05) of greater weights (p<0.05) with little cosmetic penalty. There was no significant difference in margin clearance (p = 0.10) or the number of patients requiring further surgery in both groups (p=0.254).

Conclusion: OPS provides a better cosmetic and oncological result compared to standard wide local excisions based on the weight and size of the tumor. Margin clearance is comparable in both groups. When breast conserving surgery is recommended, oncoplastic methods provide a better outcome in patients requiring a larger excision and can decrease the mastectomy rate in cases of larger tumors.