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First international consensus conference on standardization of oncoplastic breast conserving surgery

Breast Cancer Research and Treatment volume 165, pages 139–149 (2017)Cite this article

Abstract

Purpose

To obtain consensus recommendations for the standardization of oncoplastic breast conserving surgery (OPS) from an international panel of experts in breast surgery including delegates from the German, Austrian and Swiss societies of senology.

Methods

A total of 52 questions were addressed by electronic voting. The panel’s recommendations were put into context with current evidence and the report was circled in an iterative open email process until consensus was obtained.

Results

The panelists considered OPS safe and effective for improving aesthetic outcomes and broadening the indication for breast conserving surgery (BCS) towards larger tumors. A slim majority believed that OPS reduces the rate of positive margins; however, there was consensus that OPS is associated with an increased risk of complications compared to conventional BCS. The panel strongly endorsed patient-reported outcomes measurement, and recommended selected scales of the Breast-Q™-Breast Conserving Therapy Module for that purpose. The Clough bi-level classification was recommended for standard use in clinical practice for indicating, planning and performing OPS, and the Hoffmann classification for surgical reports and billing purposes. Mastopexy and reduction mammoplasty were the only two recognized OPS procedure categories supported by a majority of the panel. Finally, the experts unanimously supported the statement that every OPS procedure should be tailored to each individual patient.

Conclusions

When implemented into clinical practice, the panel recommendations may improve safety and effectiveness of OPS. The attendees agreed that there is a need for prospective multicenter studies to optimize patient selection and for standardized criteria to qualify and accredit OPS training centers.

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Funding

No commercial funding was received for this conference.

Author information

Author notes

  1. Walter P. Weber and Savas D. Soysal have contributed equally to this work.

Affiliations

  1. Breast Center, University Hospital Basel, Basel, Switzerland

    Walter P. Weber, Savas D. Soysal, Elisabeth A. Kappos, Fabienne Schwab, Martin Haug & Christian Kurzeder

  2. Breast Center St. Gallen, St. Gallen, Switzerland

    Michael Knauer

  3. Memorial Sloan Kettering Cancer Center, New York, USA

    Mahmoud El-Tamer & Virgilio Sacchini

  4. Gynecology with Breast Center, Charité Universitätsmedizin Berlin, Berlin, Germany

    Jens-Uwe Blohmer

  5. Breast Center, Hirslanden Klinik St. Anna, Lucerne, Switzerland

    Peter Dubsky

  6. Department of Surgery and Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria

    Florian Fitzal & Peter Dubsky

  7. Breast-Center Zurich, Zurich, Switzerland

    Christoph Tausch

  8. Breast Center Hirslanden Clinics Aarau Cham Zug and frauenarztzentrum aargau ag, Baden, Switzerland

    Nik Hauser

  9. Department of Obstetrics and Gynecology, Cantonal Hospital of Lucerne, Lucerne, Switzerland

    Andreas Günthert

  10. Division of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano (ORL), Breast Centre of Switzerland (CSSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland

    Yves Harder

  11. Universitäts-Brustzentrum, Universitäts-Frauenklinik, Im Neuenheimer Feld 440, Heidelberg, Germany

    Jörg Heil

  12. Breast Center, University Hospital Frankfurt, Frankfurt, Germany

    Christine Solbach

  13. Department of Women’s Health, University Breast Center Tubingen, Tübingen, Germany

    Markus Hahn

  14. Breast Surgery Unit at the Department of Ob/Gyn, University Hospital Rostock, Suedring 81, 18059, Rostock, Germany

    Bernd Gerber

  15. Breast Center, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany

    Jürgen Hoffmann

  16. Department of Gynecology, Medical Univerisity Graz, Auenbruggerplatz 14, 8036, Graz, Austria

    Vesna Bjelic-Radisic

  17. Breast Center at the English Garden, Munich, Germany

    Christoph Heitmann

  18. Breast Center Salzburg, University Clinic Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria

    Roland Reitsamer

  19. Plastische, Ästhetische und Rekonstruktive Chirurgie, Wilhelminenspital der Stadt, Vienna, Austria

    Rupert Koller

Authors
  1. Walter P. Weber
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  2. Savas D. Soysal
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  3. Mahmoud El-Tamer
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  5. Michael Knauer
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  9. Yves Harder
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  10. Elisabeth A. Kappos
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  11. Fabienne Schwab
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  12. Florian Fitzal
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  13. Peter Dubsky
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  14. Vesna Bjelic-Radisic
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  15. Roland Reitsamer
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  16. Rupert Koller
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  17. Jörg Heil
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  18. Markus Hahn
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  19. Jens-Uwe Blohmer
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  20. Jürgen Hoffmann
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  21. Christine Solbach
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  22. Christoph Heitmann
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  23. Bernd Gerber
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  24. Martin Haug
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  25. Christian Kurzeder
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Corresponding author

Correspondence to Walter P. Weber.

Ethics declarations

Conflict of interest

Author Florian Fitzal invented the Breast Analyzing Tool (BAT) for symmetry measurements in breast surgery. Walter P. Weber, Savas D. Soysal, Mahmoud El-Tamer, Virgilio Sacchini, Michael Knauer, Christoph Tausch, Nik Hauser, Andreas Günthert, Yves Harder, Elisabeth A Kappos, Fabienne Schwab, Peter Dubsky, Vesna Bjelic-Radisic, Roland Reitsamer, Rupert Koller, Jörg Heil, Markus Hahn, Jens-Uwe Blohmer, Jürgen Hoffmann, Christine Solbach, Christoph Heitmann, Bernd Gerber, Martin Haug, Christian Kurzeder declare that they have no conflict of interest in the context of this publication.

Additional information

Jörg Heil, Markus Hahn, Jens-Uwe Blohmer, Jürgen Hoffmann, Christine Solbach, Christoph Heitmann, Bernd Gerber—Official delegates of the German Society of Senology.

Florian Fitzal, Vesna Bjelic-Radisic, Roland Reitsamer, Rupert Koller—Official delegates of the Austrian Society of Senology.

Walter P. Weber, Savas D. Soysal, Michael Knauer, Christoph Tausch, Nik Hauser, Andreas Günthert, Yves Harder—Official delegates of the Swiss Society of Senology.

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Weber, W.P., Soysal, S.D., El-Tamer, M. et al. First international consensus conference on standardization of oncoplastic breast conserving surgery. Breast Cancer Res Treat 165, 139–149 (2017). https://doi.org/10.1007/s10549-017-4314-5

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  • DOI: https://doi.org/10.1007/s10549-017-4314-5

Keywords

  • Oncoplastic surgery
  • Breast conserving surgery
  • Breast surgery
  • Breast cancer