Oncoplastic Breast Reduction Technique and Outcomes: An Evolution over 20 Years

Area of Science:

• Oncoplastic surgery
• Breast cancer treatment
• Plastic surgery

Background:

• Reduction mammaplasty at the time of lumpectomy is a viable option for breast cancer patients with macromastia.
• This study critically evaluates refinements and outcomes of this oncoplastic technique.

Purpose of the Study:

• To evaluate the refinements and outcomes of combining reduction mammaplasty with lumpectomy for breast cancer patients.
• To assess patient satisfaction and oncologic safety of the procedure.

Main Methods:

• A review of a prospectively maintained database of patients who underwent lumpectomy and reduction mammaplasty between 1994 and 2015.
• Analysis of patient demographics, preoperative and postoperative satisfaction (BREAST-Q), and comparison between early and recent cases.

Main Results:

• 353 patients were included; average age 54, stage I disease most common.
• Positive margin rate was 6.2%, completion mastectomy rate 9.9%, and recurrence rate 5.2%.
• Resections >1000g correlated with positive margins (p=0.016) and tended towards completion mastectomy (p=0.069). Patient-reported outcomes, including self-confidence and emotional health, improved postoperatively.

Conclusions:

• Oncoplastic reduction mammaplasty is an effective breast cancer treatment, enhancing patient-reported outcomes.
• Large resection weights (>1000g) are linked to higher positive margin rates and potential need for completion mastectomy.
• Surgical outcomes have improved over time due to technique refinement and increased experience.