Extreme Oncoplastic Surgery for Conservation of Breast in Locally Advanced, Multifocal and Multicentric Breast Cancer

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Menoufia University, Menoufia, Egypt

10.21608/asjs.2025.413616.1229

Abstract

Introduction: For individuals with locally advanced, multi-focal or multi-centric breast cancer (MFMC), extreme
oncoplastic breast conservation surgery (EOBCS) may be a possibility. By improving esthetic results and oncological
safety, Extreme Oncoplasty (EO) expands the indications of breast conservative surgery (BCS) for patients who
would otherwise need mastectomy.
Aim of work: To study the feasibility of extreme oncoplastic surgery for conservation of breast in locally advanced
multifocal and multicentric breast courser.
Patients and methods: The study is prospective and retrospective, and comprised 40 patients who presented to
Menoufia University Hospitals between 2020 and 2024 with tumors ≥ 50 mm or who had MF/MC in two adjacent
quadrants. Therapeutic Reduction Mammoplasty (TRM) with immediate or delayed contralateral symmetry was
provided to patients with big ptotic breasts (cup D). Lateral mammaplasty procedures were offered to patients with
medium-sized breasts (cup B, C) with the same tumor criteria.
Results: Forty patients were included in the study with a median age of 55 years (range 37-70). Clear margins
were achieved in 39 (97.5%) patients, 1 (2.5%) patient showed inadequate margins at final histopathology
analysis and required a completion mastectomy. None of participants got major complications. Minor complications
as delayed healing of wound (17.5%), wound infection and dehiscence that required antibiotics (7.5%), seroma
(7.5%), all managed conservatively. Regarding score of satisfaction, were (excellent) in 17 cases (42.5%), (good)
in 21 cases (52.5%), and (fair) in 2 cases (5%).
Conclusion: For patients with breast cancer whose tumors are ≥ 50 mm or MF/MC, extreme oncolastic surgery
is a good option with a low rate of complications and high patient satisfaction. So, it may be regarded as an
oncologically safe alternative to mastectomy.

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