The adoption of oncoplastic surgery using breast reduction or mastopexy techniques in an academic breast cancer center program can increase breast conservation rates
Yurie Sekigami, MD1, Ritam Chowdhury, MBBS, MPH, PhD, SM1, Lilian Chen, MD1, Abhishek Chatterjee, MD, MBA1 1Tufts Medical Center, Boston, MA, USA
Background
Interest in oncoplastic surgery (OPS), a form of breast conservation surgery (BCS), has grown in the U.S. over the last decade. The purpose of this study was to investigate whether the adoption of OPS increases BCS rates and decreases mastectomy rates at the institutional level.
Methods
A retrospective study of breast cancer patients in a single institution database was performed. Rates of BCS vs mastectomy and partial mastectomy vs OPS were measured between 2012-2018 to capture 3 years prior and 3 years after the hiring of an oncoplastic surgeon in 2015. These rates were further stratified by pathologic T stage. Z-test for proportions was used to test the difference between mastectomy and BCS rates in 2012 and 2018.
Results
674 patients were included in the study. There was a statistically significant (p<0.0001) increase in BCS rate from 51% to 83% between 2012 and 2018. The point of maximum divergence favoring BCS was in 2015. When stratified by pathologic T stage, rates of mastectomy for T2 tumors decreased precipitously after 2015 and BCS increased proportionately (Figure 1). The rate of BCS for T1 tumors also increased but less drastically.
Conclusion
The adoption of oncoplastic surgery in an academic breast cancer center can result in significantly higher rates of BCS, particularly for those with larger tumors (T2).
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