Prediction of Local Recurrence After Oncoplastic Breast Surgery: Analysis of a Large Cohort

J Surg Res. 2021 Dec:268:267-275. doi: 10.1016/j.jss.2021.07.001. Epub 2021 Aug 12.

Abstract

Background: Oncoplastic breast surgery (OBS) is becoming an acceptable procedure for the surgical treatment of breast cancer; however, its safety and recurrence rate still need further clarification. This study evaluates the rate of local recurrence and its predictive factors after OBS in a large series of patients.

Materials and methods: This study was conducted between January 2008 and June 2018 in two centers in Iran. Patients underwent OBS, and baseline characteristics were recorded. Patients underwent regular follow-up; local recurrence rate, median time, and the hazard ratio of predictive factors were calculated. Also, a multivariate analysis was performed.

Results: A total of 676 patients with a mean age of 48 ± 10.7 y were included. The median follow-up time was 26.4 (first, third IQR: 13.2, 45.6) mo, and 37 (5.5%) patients were diagnosed with local recurrence. The median time to local recurrence was 22.0 (first, third IQR: 16.0, 32.8) mo. Pathological N stage, neoadjuvant chemotherapy, overexpression of HER2, and one surgery technique was associated with a higher risk of recurrence, while the expression of estrogen receptor and progesterone receptor (PR) decreased the risk of recurrence. PR status, neoadjuvant chemotherapy, and pathological N stage remained significant in the final model for recurrence on multivariate analysis.

Conclusion: OBS is a safe technique with an acceptable risk of local recurrence. PR status, neoadjuvant chemotherapy, and pathological N stage can predict recurrence in these patients with an acceptable power.

Keywords: Breast cancer; Local recurrence; Oncologic outcomes; Oncoplastic breast surgery; Predictive factor.

MeSH terms

  • Adult
  • Breast / pathology
  • Breast / surgery
  • Breast Neoplasms* / pathology
  • Female
  • Humans
  • Mastectomy / adverse effects
  • Mastectomy, Segmental* / adverse effects
  • Mastectomy, Segmental* / methods
  • Middle Aged
  • Neoadjuvant Therapy
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / etiology
  • Neoplasm Recurrence, Local / surgery
  • Receptor, ErbB-2 / metabolism
  • Retrospective Studies

Substances

  • Receptor, ErbB-2