Oncoplastic Breast-Conserving Surgery in Iceland: A Population-Based Study.

Abstract

In Iceland, oncoplastic breast-conservation surgery has been performed since 2008. The aim of this population-based study was to assess and compare the efficacy and patient satisfaction of standard breast-conservation surgery with oncoplastic breast-conservation surgery. This is a population-based, retrospective, observational cohort study on all women undergoing breast-conservation surgery in Iceland from the 1 January 2008 to 31 December 2014. A multivariate logistic regression and linear regression were performed to assess differences in outcomes and a patient satisfaction questionnaire was used to assess certain patient-related outcome measures. A total of 750 women underwent breast-conserving surgery, 665 had standard breast-conservation surgery and 85 oncoplastic breast-conservation surgery. Oncoplastic breast-conservation surgery was associated with a significantly larger mean size (2.4 cm vs 1.7 cm, p < 0.001) and weight (181.8 g vs 63.4 g, p < 0.001) of breast specimen excised when compared to standard breast-conservation surgery. After correcting for confounding factors, there was no significant difference in surgical margin involvement (odds ratio = 0.97, confidence interval = 0.44-1.97), frequency of complications (odds ratio = 1.06, confidence interval = 0.46-2.18), frequency of reoperations (odds ratio = 0.98; confidence interval = 0.50-1.81), or time to first adjuvant therapy (-0.23 days for oncoplastic breast-conservation surgery, p = 0.95). Patient satisfaction was high in both groups, although not statistically different (96% in oncoplastic breast-conservation surgery group vs 89% in the standard breast-conservation surgery group, p = 0.84). Our results show that oncoplastic breast-conservation surgery is at least as safe as standard breast-conservation surgery in selected cases and may be preferable in ductal carcinoma in situ.