Oncoplastic versus Conventional Breast-Conserving Surgery: Re-Excision Rates, Local Recurrence, and Patient-Reported Outcomes: A Systematic Review
DOI:
https://doi.org/10.65759/8txk1p41Keywords:
Breast cancer, oncoplastic surgery, breast-conserving surgery, re-excision, local recurrenceAbstract
Background: Oncoplastic breast-conserving surgery integrates cancer excision with immediate breast reshaping. Its comparative value involves repeat surgery, local disease control, and patient experience. Our review examined the outcomes against conventional breast conservation. Methods: Comparative original reports published through 31 May 2026 were included. Study characteristics, surgical outcomes, follow-up, and validated patient-reported measures were extracted from accessible publications. Findings were synthesized narratively, with re-excision distinguished from broader reoperation and local recurrence distinguished from composite survival endpoints. Results: Thirteen comparative reports included one randomized trial and twelve observational investigations. Several cohorts reported fewer repeat operations after oncoplastic surgery, including a Danish nationwide analysis reporting re-excision in 14.1% versus 15.6%. Saudi cohort reported re-excision in 26.3% versus 13.0%. Comparative recurrence analyses did not establish a consistent difference in local control. The randomized trial show improved five-year body image following simple defect closure without a significant re-excision difference. Patient-reported findings varied: selected studies favored psychosocial well-being or satisfaction, whereas a prospective multicenter cohort reported less favorable body image. Differences in surgical selection, instruments, and assessment timing limited direct comparisons. Conclusion: Oncoplastic surgery expands breast-conserving options and is associated with fewer repeat excisions in several settings. The available comparisons do not establish superior local control or universally better patient-reported outcomes. Treatment selection requires individualized discussion of oncological requirements, reconstructive extent, and patient priorities.
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