Oncoplastic breast reduction surgery decreases rates of reoperation with no increased medical risk

Abstract

The purpose of this study is to compare the oncologic, medical, and surgical outcomes of lumpectomy versus oncoplastic breast reduction surgery (OBRS) on a national scale. A national insurance-based database was queried for patients who had a lumpectomy with or without a same-day breast reduction by Current Procedural Terminology (CPT) codes. Patients were then matched by obesity, body mass index range, age, region, neoadjuvant chemotherapy, and outcomes were compared. There were 421,455 patients in the lumpectomy group and 15,909 patients in the OBRS group. After matching, 15,134 patients were identified in each group. Repeat lumpectomy or subsequent mastectomy was more common in the lumpectomy group (15.2% vs. 12.2%, p<0.001). OBRS patients had higher rates of 90-day surgical complications including dehiscence, infection, fat necrosis, breast abscesses, and antibiotic prescription (p<0.001). Meanwhile, any medical complication was less common in the OBRS group (3.7% vs. 4.5%, p=0.001). Logistic regression revealed that OBRS was associated with decreased odds of repeat lumpectomy (OR=0.71, 95% CI 0.66-0.77, p<0.001) with no significant increased odds of subsequent mastectomy (OR=1.01, 95% CI 0.91-1.11, p=0.914).OBRS was found to be associated with decreased risk for reoperation in the form of lumpectomy without increased likelihood of subsequent mastectomy. Although OBRS was associated with increased wound complications, medical complications were found to occur less frequently. This study endorses increased consideration of OBRS when lumpectomy or OBRS is appropriate.