Oncoplastic Breast-Conserving Surgery in Iceland: A Population-Based Study

Background and Aims: In Iceland, oncoplastic breast-conservation surgery has been performed since 2008. The aim of this population-based study was to assess and compare the efficacy and patient satisfaction of standard breast-conservation surgery with oncoplastic breast-conservation surgery. Materials and methods: This is a population-based, retrospective, observational cohort study on all women undergoing breast-conservation surgery in Iceland from the 1 January 2008 to 31 December 2014. A multivariate logistic regression and linear regression were performed to assess differences in outcomes and a patient satisfaction questionnaire was used to assess certain patient-related outcome measures. Results and conclusion: A total of 750 women underwent breast-conserving surgery, 665 had standard breast-conservation surgery and 85 oncoplastic breast-conservation surgery. Oncoplastic breast-conservation surgery was associated with a significantly larger mean size (2.4cm vs 1.7cm, p<0.001) and weight (181.8g vs 63.4g, p<0.001) of breast specimen excised when compared to standard breast-conservation surgery. After correcting for confounding factors, there was no significant difference in surgical margin involvement (odds ratio=0.97, confidence interval=0.44-1.97), frequency of complications (odds ratio=1.06, confidence interval=0.46-2.18), frequency of reoperations (odds ratio=0.98; confidence interval=0.50-1.81), or time to first adjuvant therapy (-0.23days for oncoplastic breast-conservation surgery, p=0.95). Patient satisfaction was high in both groups, although not statistically different (96% in oncoplastic breast-conservation surgery group vs 89% in the standard breast-conservation surgery group, p=0.84). Our results show that oncoplastic breast-conservation surgery is at least as safe as standard breast-conservation surgery in selected cases and may be preferable in ductal carcinoma in situ.