Comparing Complications in Oncoplastic versus Benign Breast Reductions: A 9-year Retrospective Review
Andrew Marano, Karan Grover, MD, PharmD, Anya Peysakhovich, PA-C, Alexandra J. Lin, BA, Wendy Castillo, PhD, Christine H. Rohde, MD, MPH, FACS.
Columbia/Cornell, New York, NY, USA.
BACKGROUND: Recent studies suggest that oncoplastic breast reconstruction following partial mastectomy with concurrent symmetrizing breast reduction improves cosmetic outcomes when compared to standard breast conservation therapy alone. Because the approach to reconstruction following lumpectomy is dictated by the extirpation, one could hypothesize that the complication profile could be less favorable than it would be for a standard breast reduction. The purpose of this study is to determine whether or not tailoring a breast reduction to a cancer resection has an effect on complication rates by comparing outcomes 1) between oncoplastic breast reduction patients and those who had a breast reduction for benign macromastia and 2) between the cancer side and symmetrizing side of an oncoplastic reduction.
METHODS: This IRB-approved retrospective chart review was performed on patients who underwent either oncoplastic breast reduction or bilateral breast reduction for benign macromastia between January 2010 and October 2018. Patient demographics, intraoperative data, and postoperative outcomes were gathered. Specific outcomes tracked included SSI, hematoma, seroma, prolonged wound healing, nipple loss, loss of nipple sensation, fat necrosis, and revisional surgery.
RESULTS: A total of 211 patients were included in this study: 62 (29.4%) oncoplastic and 149 (70.6%) benign macromastia. Mean age was significantly greater in the oncoplastic group (52 vs 40, p=0.00), as was the rate of diabetes (16 vs. 6%, p=0.02) and length of surgery (265 vs. 216 min, p=0.00). Total resection weight was greater in the benign group (1623 vs 1096 g, p=0.00). There were no significant differences in BMI or smoking status. There was a higher rate of loss of nipple sensation in the oncoplastic group (p=0.005), but no differences in other complications. Furthermore, there were no significant differences in the rates of any complications when comparing the oncoplastic breasts to the symmetrizing breasts within the oncoplastic cohort.
CONCLUSIONS: This study offers a 9 year experience with over 200 oncoplastic and benign breast reductions. While the loss of nipple sensation was increased in patients undergoing oncoplastic breast reduction, all other outcomes were not significantly different between the two groups. There were also no differences in complication rates when comparing the side of malignancy to the symmetrizing side. While oncoplastic breast reduction poses challenges that may theoretically increase rates of complication and asymmetry, our findings indicate that it can be performed with similar safety profile to that of a standard breast reduction.
Back to 2019 Abstracts