Feasibility of level II oncoplastic techniques in the surgical management of locally advanced breast cancer after neoadjuvant treatment.

Abstract

The study aimed to identify the short- and long-term oncological results and complications of level-II oncoplastic surgery (OPS) techniques applied after neoadjuvant chemotherapy (NAC) for locally advanced breast cancer. Patients undergoing OPS because of breast cancer (non-NAC) and those undergoing OPS after systemic treatment (NAC) were evaluated. Surgical margin (SM) status, reoperation and re-excision requirements, axillary intervention results, ipsilateral tumour recurrence, axillary recurrence rates and early postoperative complications were recorded. Long-term locoregional recurrence-free survival (LRFS) and overall survival (OS) rates of the patients were analysed. There were 1043 patients (893 patients in the non-NAC group and 150 in the NAC group) in the study. There were no significant differences in SM status, re-excision and mastectomy rates between the groups. The 5-year (LRFS) rate was 90.1% in the NAC group and 93.2% in the non-NAC group (P: .09). OS was shorter in the NAC group. Five-year OS rate was 96% in the non-NAC group and 92% in the NAC group (P: .01). There was no significant difference between the groups in terms of delayed wound healing, minor wound infection, fat necrosis, seroma/hematoma, partial nipple necrosisor T-junction necrosis. It should be noted that the responses to NAC increased with targeted therapies, and breast-conserving became possible in a substantial number of patients who were not eligible for breast-conserving surgery at the first presentation. Notably, oncoplastic surgery increased breast conservation rates without compromising oncological results.