Journal
JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
Volume 88, Issue -, Pages 273-280Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.bjps.2023.10.134
Keywords
Oncoplastic breast; reduction surgery; Breast; reconstruction; Breast cancer; Breast conservation
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The study aims to compare the oncologic, medical, and surgical outcomes of lumpectomy and oncoplastic breast reduction surgery (OBRS) on a national scale. A database was used to analyze patient data and match them based on various factors. The results showed that lumpectomy patients had higher rates of repeat lumpectomy or subsequent mastectomy, while OBRS patients had higher rates of surgical complications but fewer medical complications. Logistic regression analysis revealed that OBRS was associated with a decreased likelihood of repeat lumpectomy. Although OBRS was associated with increased wound complications, medical complications were found to occur less frequently.
The purpose of this study is to compare the oncologic, medical, and surgical outcomes of lumpectomy versus oncoplastic breast reduction surgery (OBRS) on a national scale. A national in- surance-based database was queried for patients who had a lumpectomy with or without a same-day breast reduction by Current Procedural Terminology (CPT) codes. Patients were then matched by obesity, body mass index range, age, region, neoadjuvant chemotherapy, and outcomes were com- pared. There were 421,455 patients in the lumpectomy group and 15,909 patients in the OBRS group. After matching, 15,134 patients were identified in each group. Repeat lumpectomy or subsequent mastectomy was more common in the lumpectomy group (15.2% vs. 12.2%, p < 0.001). OBRS pa- tients had higher rates of 90-day surgical complications including dehiscence, infection, fat necrosis, breast abscesses, and antibiotic prescription (p < 0.001). Meanwhile, any medical complication was less common in the OBRS group (3.7% vs. 4.5%, p = 0.001). Logistic regression revealed that OBRS was associated with decreased odds of repeat lumpectomy (OR = 0.71, 95% CI 0.66-0.77, p < 0.001) with no significant increased odds of subsequent mastectomy (OR = 1.01, 95% CI 0.91-1.11, p = 0.914). OBRS was found to be associated with decreased risk for reoperation in the form of lumpectomy without increased likelihood of subsequent mastectomy. Although OBRS was associated with increased wound complications, medical complications were found to occur less frequently. This study endorses increased consideration of OBRS when lumpectomy or OBRS is appropriate. (c) 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
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