An alternative to standard lumpectomy: a 5-year case series review of oncoplastic breast surgery outcomes in a Canadian setting

Background: Oncoplastic surgery (OPS) is becoming the new standard of care for breast-conserving surgery (BCS). It has become increasingly popular in Europe; however, it has not yet been widely accepted in North America. This study aims to describe the experience with OPS at a Canadian tertiary care centre. Methods: This study is a retrospective case series consisting of consecutive OPS cases at a single Canadian centre, the Royal Victoria Regional Health Centre in Barrie, Ontario, between 2009 and 2015. Results: A total of 275 women who consecutively underwent OPS were included. The average size of the tumour was 17 mm (standard deviation [SD] 13 mm; range 0-110 mm). The average specimen weight was 155 g (SD 146 g; range 15-1132 g). Invasive ductal carcinoma was the most common diagnosis (237 patients, 86.2%), followed by ductal carcinoma in situ (18 patients, 6.6%) and then invasive lobular carcinoma (15 patients, 5.5%). A positive margin was recorded in 37 (13.5%) patients. Immediate postoperative complications included seroma and edema (32.7%), wound infection (13.1%), hematoma (8.7%) and delayed wound healing (6.5%). A delay to adjuvant therapy due to postoperative complications occurred in 7 of 217 (3.2%) patients. The median follow-up was 18 months. There were local and distant recurrences in 9 (3.3%) and 2 (0.7%) patients, respectively. Overall survival was 99.3%. Conclusion: The findings of this study are comparable to results in the literature on OPS and demonstrate that OPS is an attractive alternative to standard lumpectomy for Canadian general surgeons who treat breast cancer.