Oncological safety and short-term aesthetic outcome of extreme oncoplasty for breast cancer.

BACKGROUND: For individuals with breast cancer, oncoplastic breast surgery (OBS), is considered an innovative technique of breast conservative surgery (BCS), has emerged as the recommended substitute for mastectomy. BCS and mastectomy have been shown to have comparable locoregional control and overall survival in randomized trials. In order to ensure oncological safety and improved aesthetic results, Extreme Oncoplasty, a development in the field of oncoplasty, has given hope for patient to achieve ultimate conservation before mastectomy. PATIENTS AND METHODS: From October 2021 to May 2023, fifty patients fulfilling our eligibility criteria underwent extreme oncoplasty for breast cancer have been included in the current study. Reduction mammoplasty (superomedial, superiolateral and inferior pedicle), upper matrix rotational flap, and Passot’s technique were our adopted surgical techniques. One year following surgery, short-term aesthetic results were objectively assessed using Breast Cancer Conservative Treatment (BCCT) core program. RESULTS: Our study has included 50 cases with age range from 35 to 61 years (mean 52.28 ± 6.3). 38 patients presented with tumor size more than 5 cm not responding to the neoadjuvant therapy for downsizing and 12 patients presented with multifocal lesions. The total aesthetic results according to the BCCT core software were good in 52% (26 cases), fair in 34% (17 cases) and poor in 14% (7 cases). Our study has reported two cases of recurrence (4%) one year after surgery which were managed via mastectomy. CONCLUSION: According to short-term follow-up, extreme oncoplasty is oncologically safe. To provide patients with advanced or multifocal breast cancer with extreme oncoplasty as a viable alternative, large-scale research are needed to validate these first findings.