Annals of Surgical Oncology

, Volume 23, Issue 6, pp 1852–1859 | Cite as

Oncoplastic Breast-Conserving Surgery for Tumors Larger than 2 Centimeters: Is it Oncologically Safe? A Matched-Cohort Analysis

  • Francesca De Lorenzi
  • Pietro Loschi
  • Vincenzo Bagnardi
  • Nicole Rotmensz
  • Gabriel Hubner
  • Giovanni Mazzarol
  • Roberto Orecchia
  • Viviana Galimberti
  • Paolo Veronesi
  • Marco Angelo Colleoni
  • Antonio Toesca
  • Nickolas Peradze
  • Rietjens Mario
Breast Oncology



Oncoplastic surgery is a well-established approach that combines conserving treatment for breast cancer and plastic surgery techniques. Although this approach has been described for T2 tumors, no long-term oncologic follow-up and no comparison with patients undergoing mastectomy has been published. The purpose of the study was to demonstrate that oncoplastic surgery is a safe and reliable treatment for managing invasive primary T2 breast cancer.


We compared a consecutive series of 193 T2 patients who have undergone oncoplastic surgery (study group) with 386 T2 patients who have undergone mastectomy (control group). The endpoints evaluated were disease-free survival (DFS), overall survival (OS), cumulative incidence of local recurrence (CI-L), regional recurrence (CI-R), and distant recurrence (CI-D), all measured from the date of surgery.


Median follow-up is 7.4 years. The OS is similar within the two groups: 87.3 and 87.1 % at 10 years in the ONC group and control group, respectively (p value, adjusted for multifocality and tumor size, 0.74). Also, the DFS is similar in both groups: 60.9 and 56.3 % at 10 years in the ONC group and control group, respectively. The incidence of local events is slightly higher in the oncoplastic group, whereas the incidence of regional events is slightly higher in the mastectomy group. These differences are not statistically significant. The cumulative incidence of distant events is similar within the two groups.


To our knowledge, the present study provides the best available evidence to suggest that oncoplastic approach is a safe and reliable treatment for managing invasive pT2 breast cancers.


Overall Survival Mastectomy Group Muscular Flap Pedicled Reduction Additional Boost Dose 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



None of the authors has any commercial associations or financial interests to disclose. None of the authors received any funding for this work from any of the following organizations: National Institutes of Health (NIH); Wellcome Trust; Howard Hughes Medical Institute (HHMI); and other(s). Statement of Istitutional review board approval and/or statement of conforming to the declaration of Helsinky. This study is in compliance with the principles of the Helsinki Declaration.


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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Francesca De Lorenzi
    • 1
  • Pietro Loschi
    • 1
  • Vincenzo Bagnardi
    • 2
    • 3
  • Nicole Rotmensz
    • 2
  • Gabriel Hubner
    • 1
  • Giovanni Mazzarol
    • 4
  • Roberto Orecchia
    • 5
  • Viviana Galimberti
    • 6
  • Paolo Veronesi
    • 6
  • Marco Angelo Colleoni
    • 7
  • Antonio Toesca
    • 6
  • Nickolas Peradze
    • 6
  • Rietjens Mario
    • 1
  1. 1.Department of Plastic and Reconstructive SurgeryEuropean Institute of OncologyMilanItaly
  2. 2.Division of Epidemiology and BiostatisticsEuropean Institute of OncologyMilanItaly
  3. 3.Department of Statistics and Quantitative MethodsUniversity of Milan-BicoccaMilanItaly
  4. 4.Division of Pathology and Laboratory MedicineEuropean Institute of OncologyMilanItaly
  5. 5.Division of RadiotherapyEuropean Institute of OncologyMilanItaly
  6. 6.Department of SurgeryEuropean Institute of OncologyMilanItaly
  7. 7.Medical SenologyEuropean Institute of OncologyMilanItaly

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