Journal Article

Retrospective, Multicenter Analysis Comparing Conventional with Oncoplastic Breast Conserving Surgery: Oncological and Surgical Outcomes in Women with High-Risk Breast Cancer from the OPBC-01/iTOP2 Study

Papassotiropoulos Bärbel, Ritter, Mathilde, Sander, Steffen, Alberti Andrea S M, Trapp, Elisabeth K, Ostapenko Valerijus, Morrow, Elizabeth, Bonollo, Marta, Schrenk, Peter, Riedel Fabian, Meani Francesco, Bolliger, Michael, Matrai Zoltan, Paulinelli, Regis R, Ostapenko Andrej, Pristauz-Telsnigg, Gunda, Pukancsik Dávid, Andre, Camilla, Heck Dietmar, Montagna Giacomo, Burneckis Arvydas, Gambone Luca, Acko Markus, Fitzal Florian, Weber, Walter Paul, de Boniface Jana, Geroldinger Angelika, Paliczek, Clara, Jens-Uwe, Blohmer, Ostapenko Edvin, Heil Jörg, Romics Laszlo, Harder, Yves, Fehrer Hans-Jörg, Helfgott, Ruth, Dunkler Daniela, Tausch Christoph, Lorenz Katharina, Fehr, Mathias

2022

Overview

IntroductionRecent data suggest that margins ≥2 mm after breast-conserving surgery may improve local control in invasive breast cancer (BC). By allowing large resection volumes, oncoplastic breast-conserving surgery (OBCII; Clough level II/Tübingen 5-6) may achieve better local control than conventional breast conserving surgery (BCS; Tübingen 1-2) or oncoplastic breast conservation with low resection volumes (OBCI; Clough level I/Tübingen 3-4).MethodsData from consecutive high-risk BC patients treated in 15 centers from the Oncoplastic Breast Consortium (OPBC) network, between January 2010 and December 2013, were retrospectively reviewed.ResultsA total of 3,177 women were included, 30% of whom were treated with OBC (OBCI n = 663; OBCII n = 297). The BCS/OBCI group had significantly smaller tumors and smaller resection margins compared with OBCII (pT1: 50% vs. 37%, p = 0.002; proportion with margin <1 mm: 17% vs. 6%, p < 0.001). There were significantly more re-excisions due to R1 (“ink on tumor”) in the BCS/OBCI compared with the OBCII group (11% vs. 7%, p = 0.049). Univariate and multivariable regression analysis adjusted for tumor biology, tumor size, radiotherapy, and systemic treatment demonstrated no differences in local, regional, or distant recurrence-free or overall survival between the two groups.ConclusionsLarge resection volumes in oncoplastic surgery increases the distance from cancer cells to the margin of the specimen and reduces reexcision rates significantly. With OBCII larger tumors are resected with similar local, regional and distant recurrence-free as well as overall survival rates as BCS/OBCI.

• Publisher: Springer Nature B.V
• Subject: Breast cancer / Invasiveness / Lumpectomy / Radiation therapy / Surgery / Surgical outcomes / Tumors