Long-term oncological outcomes in early-stage breast cancer patients who underwent upfront oncoplastic breast-conserving surgery: Results from the Turkish Oncoplastic Breast Surgery Working Group (TOBSWG) Database
Menée à partir de données turques portant sur 3 174 patientes atteintes d'un cancer du sein de stade précoce (âge moyen : 51,9 ans ; durée moyenne de suivi : 102 mois), cette étude analyse la mortalité spécifique ainsi que les taux de récidive tumorale intra-mammaire et de récidive locale en fonction de la technique de chirurgie conservatrice utilisée
INTRODUCTION: Oncoplastic breast surgery (OPBS) techniques differ in terms of incision patterns and localizations, as well as the excision volumes they allow. There is no data yet reporting disease outcomes according to each OPBS technique applied to patients. In this study, we aimed to present long-term local control and overall mortality rates in patients recorded in the Turkish Oncoplastic Breast Surgery Working Group Database.
METHODS: Female breast cancer patients who underwent upfront OPBS for definitive treatment were included in this retrospective cohort study. Patients were grouped into 6 cohorts according to the OPBS techniques applied. Patients who underwent surgery following neoadjuvant systemic treatment were excluded. Only patients who achieved a clear margin (a minimum of no ink on the tumor) during surgery were included in the study. Primary outcome was to assess the rates of in-breast tumor recurrence (IBTR), regional recurrence (RR), BC-specific mortality (BCSM), and overall mortality (OM) in patients. Univariate and multivariate analyses were done to find the independent factors for IBTR and BCSM.
RESULTS: 3174 patients were included in the study. The most commonly used techniques were Racquet mammoplasty (26.5%) and vertical pattern mammoplasty (25%). After a 102-month follow-up period, IBTR rate was 3.9%, and the rates were similar among all surgery groups. RR, BCSM, and OM rates were 1.1%, 7.5%, and 8.4%, respectively. Having tumor subtypes of HER2+ and TN, multicentric/multifocal tumors, and failure to receive WBRT were found to be the independent factors associated with IBTR. Having tumor subtypes of HER2+ and TN and failure to receive adequate ST were independent factors related to BCSM.
CONCLUSION: Overall, upfront OPBS resulted in a less than 4% of IBTR rate after a 8,5 year follow-up in patients with early breast cancer, and the rates were not different according to OPBS subgroups. Independent factors related to IBTR were having non-luminal subtype cancers, multicentric/multifocal tumors, and failure to receive RT to the breast. Therefore, upfront OPBS seems to be a safe procedure in patients with early breast cancer with safe margins, independent of the technique applied.
European Journal of Surgical Oncology , article en libre accès, 2026