Breast Cancer: Targets and Therapy (May 2021)

Extreme Oncoplasty: Breast Conservation in Patients with Large, Multifocal, and Multicentric Breast Cancer

  • Savioli F,
  • Seth S,
  • Morrow E,
  • Doughty J,
  • Stallard S,
  • Malyon A,
  • Romics L

Journal volume & issue
Vol. Volume 13
pp. 353 – 359

Abstract

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Francesca Savioli,1,* Subodh Seth,2,* Elizabeth Morrow,1 Julie Doughty,3 Sheila Stallard,3 Andy Malyon,4 Laszlo Romics1,5 1Academic Unit of Surgery, University of Glasgow, Glasgow Royal Infirmary, Glasgow, UK; 2Department of Breast Surgery, Forth Valley Royal Hospital, Larbert, UK; 3Department of Breast Surgery, Gartnavel General Hospital, Glasgow, UK; 4Canniesburn Department of Plastic Surgery, Glasgow Royal Infirmary, Glasgow, UK; 5Department of Breast Surgery, New Victoria Hospital, Glasgow, UK*These authors contributed equally to this workCorrespondence: Francesca Savioli Email [email protected]: Extreme Oncoplastic Breast Conservation Surgery (EOBCS) is offered in selected patients with multifocal or multicentric breast cancer (MFMC). Recent evidence has suggested that EOBCS may be a valuable resource for patients with MFMC who may avoid the risk associated with mastectomy in favour of the benefits of breast conservation without risking their oncological outcomes. Our study examined the practice of EOBCS in two regional breast units in Glasgow, United Kingdom.Materials and Methods: A prospectively collected database of 50 patients treated with EOBC in two breast units in Glasgow between 2007 and 2018 were evaluated, and clinical outcomes were observed.Results: Fifty patients (median age 55) underwent EOBCS, of which 43 (86%) had invasive disease. Median tumour size was 55mm (50– 90) and multifocal disease was identified in 22 (44%) patients. Nine patients (18%) were found to have positive margins and underwent a second procedure, with 6 (12%) proceeding to mastectomy. Five-year disease free survival rate was 91.5%, while cancer-specific survival was 95.7%.Conclusion: EOBCS is oncologically safe in short-term follow-up. Large scale studies are required to confirm these preliminary results, in order to offer EOBCS as a valid option to patients with advanced or multifocal breast cancer.Keywords: extreme oncoplasty, therapeutic mammoplasty, breast conservation therapy, multifocal breast cancer, multicentric breast cancer

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