Introduction: Breast cancer conservative surgical treatment has become the standard procedure to reduce mutilation and preserve the body’s self-image. Advances in adjuvancy have widened indications for larger tumors and new trials are demonstrating safety
ONCOPLASTIC SURGERY IN THE CONSERVATIVE TREATMENT OF THE LOCALLY
ADVANCED BREAST CANCER – A SISTEMATIC REVIEW
Daniela C.C.C. E. Ribeiro(1), Cláudia A.A. Góes(2), Naiana S. C.Andrade 2), Lucas G. Ramos(3),
Luiz Fernando J. Ribeiro(4) , Régis R. Paulinelli(4)
(1) Serviço de Mastologia, Hospital Santo Antônio, Obras Sociais Irmã Dulce, Salvador, Bahia,
Brasil
(2) Serviço de Mastologia, Clínica de Assistência a Mulher, Salvador Bahia, Brasil
(3)Serviço de Mastologia, Clínica Mastos, Salvador Bahia, Brasil
(4) Serviço de Ginecologia e Mastologia, Hospital Araújo Jorge, Associação de Combate Ao
Câncer em Goiás, Goiânia, Goiás, Brasil
Abstract
Introduction: Breast cancer conservative surgical treatment has become the standard procedure to
reduce mutilation and preserve the body’s self-image. Advances in adjuvancy have widened
indications for larger tumors and new trials are demonstrating safety in locally advanced cases.
The goal of this systematic review is to evaluate the role of oncoplastic surgery in the treatment of
locally advanced breast cancer.
Methods: 523 papers were analised from pubmed electronic data base from 2012 to 2017 and 12
papers were selected to analysis with respect to design and outcomes.
Results: No randomized trial was found. Most of them were retrospective. The average tumor size
varied from 40 to 62mm. The rate of conversion of mastectomy to conservative treatment
oscilated 34–72,3%. Wise pattern was the most used technique. A greater amount of excised tissue
was found when oncoplastic surgery was performed. No diference was observed concerning
positive margins comparing the oncoplastic technique versus standard conservative treatment.
Oncoplastic tecniques showed higher rates of surgical complications but that did not delay
adjuvancy. Local regional recurrence and overall survivel varied from 9 – 14,6% and 76,7-86,6%,
respectively. Cosmetic results were considered acceptable by the patients in 84-92,3% of the
cases.
Conclusions: Oncoplastic tecniques allows greater rates of breast conservation in locally advanced
cancer cases without apparently putting at risk oncologic safety.
Key Words: breast cancer, conservative surgery, oncoplastic surgery, oncoplastic breast
conservation