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Related Experiment Video

Updated: Jun 21, 2025

Endoscopic Bilateral Nipple-sparing Mastectomy via a Single Axillary Incision with Immediate Pre-pectoral Implant-based Breast Reconstruction

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Extreme Oncoplasty: Oncologically Safe When Compared with Mastectomy.

Deena Hossino^1,2, Melvin J Silverstein^3,4, Nirav Savalia^3,4

¹Hoag Memorial Hospital Presbyterian, Newport Beach, CA, USA. deena.hossino@gmail.com.

Annals of Surgical Oncology

|July 13, 2024

Summary

Extreme oncoplasty with whole-breast radiation therapy (WBRT) offers comparable outcomes to mastectomy for extensive breast cancer. This breast-conserving approach is a viable alternative, showing no significant differences in recurrence or survival rates.

Keywords:

Avoiding mastectomy Extreme oncoplasty Multifocal/multicentric breast tumors Oncoplastic breast conservation

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Area of Science:

Surgical Oncology
Breast Surgery
Radiation Oncology

Background:

Extreme oncoplasty utilizes oncoplastic techniques for breast conservation in patients typically recommended for mastectomy.
Indications include multicentric/multifocal tumors (>50 mm) or large recurrences in irradiated breasts.

Purpose of the Study:

To compare outcomes of extreme oncoplasty plus whole-breast radiation therapy (WBRT) versus mastectomy without WBRT.
To evaluate local, regional, and distant recurrence rates, and overall/breast-cancer-specific survival.

Main Methods:

Prospective database query (2008-2023) of patients meeting extreme oncoplasty criteria.
Comparison between oncoplastic mammaplasty with WBRT (272 patients) and mastectomy without WBRT (101 patients).
Exclusion of patients with recurrent breast cancer.

Main Results:

No significant differences observed in local, regional, or distant recurrence between the two groups.
Overall survival and breast-cancer-specific survival rates were comparable between extreme oncoplasty with WBRT and mastectomy groups.
Median follow-up was 7 years.

Conclusions:

Extreme oncoplasty combined with WBRT is strongly supported as a primary treatment option.
This approach is recommended for patients with large multifocal/multicentric lesions suitable for volume displacement mammaplasty.
It provides a viable breast-conserving alternative to mastectomy.