A population-based audit of surgical practice and outcomes of oncoplastic breast conservations in Scotland - an analysis of 589 patients

Romics, L. et al. (2018) A population-based audit of surgical practice and outcomes of oncoplastic breast conservations in Scotland - an analysis of 589 patients. European Journal of Surgical Oncology, 44(7), pp. 939-944. (doi: 10.1016/j.ejso.2018.04.004) (PMID:29705287)

Abstract

Introduction: Current evidence for oncoplastic breast conservation (OBC) is based on single institutional series. Therefore, we carried out a population-based audit of OBC practice and outcomes in Scotland. Methods: A predefined database of patients treated with OBC was completed retrospectively in all breast units practicing OBC in Scotland. Results: 589 patients were included from 11 units. Patients were diagnosed between September 2005 and March 2017. High volume units performed a mean of 19.3 OBCs per year vs. low volume units who did 11.1 (p = 0.012). 23 different surgical techniques were used. High volume units offered a wider range of techniques (8–14) than low volume units (3–6) (p = 0.004). OBC was carried out as a joint operation involving a breast and a plastic surgeon in 389 patients. Immediate contralateral symmetrisation rate was significantly higher when OBC was performed as a joint operation (70.7% vs. not joint operations: 29.8%; p < 0.001). The incomplete excision rate was 10.4% and was significantly higher after surgery for invasive lobular carcinoma (18.9%; p = 0.0292), but was significantly lower after neoadjuvant chemotherapy (3%; p = 0.031). 9.2% of patients developed major complications requiring hospital admission. Overall the complication rate was significantly lower after neoadjuvant chemotherapy (p = 0.035). The 5 year local recurrence rate was 2.7%, which was higher after OBC for DCIS (8.3%) than invasive ductal cancer (1.6%; p = 0.026). 5-year disease-free survival was 91.7%, overall survival was 93.8%, and cancer-specific survival was 96.1%. Conclusion: This study demonstrated that measured outcomes of OBC in a population-based multi-centre setting can be comparable to the outcomes of large volume single centre series.

• Item Type: Articles
• Keywords: Breast conservation therapy, breast reconstruction, breast surgery, mammaplasty, mastectomy, postoperative complications, segmental.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Romics, Mr Laszlo and Campbell, Dr Esther and Weiler-Mithoff, Mrs Eva and Morrow, Dr Elizabeth and Doughty, Miss Julie and Mansell, Dr James
• Authors: Romics, L., Macaskill, E. J., Fernandez, T., Simpson, L., Morrow, E., Pitsinis, V., Tovey, S., Barber, M., Masannat, Y., Stallard, S., Weiler-Mithoff, E., Malyon, A., Mansell, J., Campbell, E. J., Doughty, J., and Dixon, J. M.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: European Journal of Surgical Oncology
• Publisher: Elsevier
• ISSN: 0748-7983
• ISSN (Online): 1532-2157
• Published Online: 13 April 2018