Is breast-conserving surgery feasible for patients with prior breast augmentation?: a single-center retrospective...

Breast cancer has the highest incidence among Korean women. With the global rise in breast augmentation, the number of patients diagnosed with breast cancer after augmentation is increasing. Surgical management in this group remains controversial, as breast-conserving surgery (BCS) followed by radiation therapy poses challenges such as capsular contracture, poor cosmetic outcomes, and difficulty obtaining clear margins. This study aimed to assess the feasibility and clinical outcomes of BCS with radiation therapy in breast cancer patients with prior augmentation.

We conducted a single-center, retrospective case series review of 4,568 patients who underwent breast cancer surgery at Korea University Guro Hospital between 2008 and 2023. Seventeen patients had prior breast augmentation. Clinical records, imaging, pathology, and surgical data were reviewed for tumor characteristics, implant placement, treatment, and recurrence. Postoperative mammography was used to assess breast symmetry.

Of the 17 patients (mean age, 46 years), 16 underwent BCS and 1 underwent mastectomy due to extensive microcalcification. Tumor stages ranged from ductal carcinoma in situ to stage IIB. One local recurrence occurred 7 years after surgery. The mean breast volume difference between the treated and untreated breast was 104 mL. No implant rupture or removal occurred during surgery.

Our findings suggest that BCS with radiation therapy is a feasible treatment option for patients with prior augmentation, as adequate margins were achieved in most cases. However, postoperative breast asymmetry may occur. Given the small sample size and retrospective nature of this study, further large-scale studies are needed to confirm oncological safety and evaluate long-term cosmetic and patient-reported outcomes.