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Abstract
Purpose. Evaluation of oncological safety of oncoplastic oncoplastic resection (OR) in breast cancer patients.
Materials and Methods. A retrospective cohort controlled clinical study has been conducted with 400 stage 0-IIIC breast cancer included. Patients underwent two types of breast-conserving surgery from 2013 to 2020: oncoplastic (n=200) and standard breast-conserving resections (n=200).
Results. The groups have been analyzed in accordance with clinical and pathomorphological parameters: reliably significant differences between groups have been found / noted in the course of analysis of the patients’ menstrual status, age, tumor size, resection margin width (p<0.05). The median of the observation was 49 months. The local recurrences rate after OR and standard breast-conserving surgery (SS) was 8% and 2% respectively (p=0.006). There were no statistically significant differences found in progression and mortality rates between the two study groups.
Five-year local relapse-free survival rates were 91% and 97% for the OR and SS groups, respectively. There were no statistically significant differences in overall and recurrence-free survival found in the groups. The influence of clinical and pathomorphological indicators on the local recurrences rate was analyzed. Unfavorable prognostic factors were the lack of expression of estrogen and progesterone receptors (p<0.001), hormonal therapy (p<0.001) and radiation therapy (p=0.012); presence of the high-grade tumor (pG3=0.024), triple negative and non-luminal Her2/neu-positive type of cancer (p<0.001). The relapse rate was higher in patients with conserved menstrual status (p=0.004). Patients with diagnosed local relapse were significantly younger (p=0.001).
Conclusions. Differences between overall and relapse-free survival rates after oncoplastic breast-conserving resection and standard breast-conserving surgery have not been found. An individualized approach with unfavorable prognostic factors taken into consideration is required when planning breast-conserving surgical treatment. Large clinical trials are necessary to study the relapse rates after oncoplastic resections.
References
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