Background: Oncoplastic Breast Conserving Surgery (OBCS) is an innovative surgical approach that combines oncological resection with reconstructive techniques to improve aesthetic outcomes in early-stage breast cancer. This study aims to evaluate and compare the oncological safety, aesthetic outcomes, patient satisfaction, and cost-effectiveness of OBCS, conventional Breast Conserving Surgery (BCS), and mastectomy with or without reconstruction in Indian women.
Methods: A retrospective cohort study was conducted on 268 women with early-stage breast cancer who underwent surgery at The First Affiliated Hospital of Chongqing Medical University between 2017 and 2021. The patients were divided into three groups: OBCS (53 patients), BCS (90 patients), and mastectomy (125 patients). Oncological outcomes (overall survival, disease-free survival, and reoperation rates) and aesthetic outcomes (measured using BREAST-Q™ version 2.0) were compared across the groups. Cost analysis was also performed.
Results: There were no significant differences in 5-year overall survival (OS) and disease-free survival (DFS) between the three groups (p>0.05). The reoperation rate was significantly lower in the OBCS group (8.4%) compared to BCS (14.5%) and mastectomy (12.0%) (p = 0.02). The OBCS group reported significantly higher satisfaction with breast appearance, psychosocial well-being, and sexual well-being compared to BCS and mastectomy groups (p<0.01). The average cost of OBCS was $1,500 USD higher than BCS but $3,000 USD lower than mastectomy with reconstruction.
Conclusion: OBCS provides oncological safety comparable to both BCS and mastectomy, with significantly better aesthetic outcomes and higher patient satisfaction. It is a cost-effective option, especially when considering both oncological and cosmetic outcomes, and should be considered as a preferred surgical option for early-stage breast cancer patients in India.
International Journal of Clinical Obstetrics and Gynaecology
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