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Oncoplastic Level 2 Mammoplasty for Large DCIS: 5-Year Results
R F D van la Parra1, K B Clough2, C Lejalle-Alaeddine1,3
1L'Institut du Sein - Paris Breast Center, Paris, France.
Annals of Surgical Oncology
|May 16, 2019
Summary
Oncoplastic surgery (OPS) is effective for ductal carcinoma in situ (DCIS) up to 50 mm, achieving a 1.9% involved margin rate. Larger tumors (>5 cm) require improved preoperative localization or wider excisions to minimize positive margins.
Area of Science:
- Surgical Oncology
- Breast Surgery
- Oncoplastic Surgery
Background:
- Oncoplastic surgery (OPS) combines cancer resection with immediate breast reshaping.
- This study focuses on level 2 mammoplasties for pure ductal carcinoma in situ (DCIS).
Purpose of the Study:
- To review the outcomes of oncoplastic level 2 mammoplasties in patients with pure DCIS.
- To evaluate involved margin rates and locoregional recurrence in this patient cohort.
Main Methods:
- Analysis of a prospectively maintained database of 392 oncoplastic level 2 mammoplasties.
- Inclusion of 68 patients with pure DCIS, assessing margin status and recurrence over a median follow-up of 76 months.
Main Results:
- Mean tumor size was 34 mm; mean resection weight was 191 g.
- 85.3% of cases had clear margins; 14.7% had involved margins.
- Tumor size >50 mm was independently associated with involved margins (OR 95.400, p<0.001).
- Breast conservation rate was 89.4%, 100% for tumors <5 cm.
- 5-year cumulative incidence for local recurrence was 5.5%.
Conclusions:
- OPS is a safe option for DCIS up to 50 mm, reducing mastectomy rates.
- Tumors >5 cm necessitate improved preoperative localization or wider excisions due to increased margin involvement.
- OPS facilitates breast conservation while managing DCIS effectively.
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