Is oncoplastic breast conserving surgery oncologically safe? A meta-analysis of 18,103 patients

Background: Oncoplastic Breast Conserving Surgery (OBCS) allows adequate resection margins of tu- mours unsuitable for standard breast conserving surgery (SBCS) whilst allowing for better cosmesis and reduced morbidity when compared to mastectomy. However, there is limited evidence on its oncological safety. Methods: This study aims to compare oncological safety of OBCS with SBCS and mastectomy by exam- ining the relative risk of cancer recurrence and re -operation rates through meta -analysis. Results: 18 studies met the search criteria including 18,103 patients. The primary outcome measure (recurrence) was not signi ficantly different between OBCS and SBCS or mastectomy (RR 0.861; 95% CI 0.640-1.160; p = 0.296). The secondary outcome measure (re -operation) initially achieved signi ficance in favour of OBCS (RR 0.64; 95% CI 0.46-0.89; p = 0.01). However, after adjustment for publication bias this was attenuated to insigni ficance between the two study groups (RR 0.86; 95% CI 0.56-1.31; p = 0.44). Conclusions: For both cancer recurrence and re -operation rate, there was no signi ficant difference be- tween OBCS and traditional techniques. OBCS is of comparable oncological safety to more established surgical procedures and a useful option in suitable patients. (c) 2020 Elsevier Inc. All rights reserved.