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Evaluating Need for Additional Imaging and Biopsy After Oncoplastic Breast-Conserving Surgery

Annals of Surgical Oncology volume 27, pages 3650–3656 (2020)Cite this article

Abstract

Introduction

Breast-conserving therapy (BCT) using oncoplastic surgery (OPS) allows for larger resections and improved aesthetics though volume redistribution and tissue rearrangement. Data regarding the impact of OPS on surveillance imaging and need for additional biopsies are limited.

Methods

This observational cohort underwent BCT at a single institution from 2009 to 2018; standard breast-conserving surgery (BCS) was the predominant approach until OPS was introduced in 2012. Rates of imaging beyond standard diagnostic views, as well as rates of biopsy following both approaches, are reported.

Results

A total of 422 consecutive patients were identified. The OPS group comprised 205 patients and the BCS group included 217 patients. There was no difference in need for additional imaging between groups (BCS: 58 patients [26.7%] vs. OPS: 53 patients [25.9%]; p = 0.91). When additional imaging was required, it was on the ipsilateral side in 35 (60.3%) BCS patients compared with 24 (45.3%) OPS patients (p = 0.21). The need for biopsy was higher in the BCS group (BCS: 41 patients [18.9%] with 47 total biopsies vs. OPS: 20 patients [9.3%] with 22 total biopsies; p < 0.01). Benign findings on biopsy were similar between groups (BCS: 18 [38.3%] vs. OPS: 11 [50.0%]; p = 0.66).

Conclusions

OPS was not associated with an increased need for additional imaging compared with BCS. Concern regarding challenges with follow-up imaging should not impact the decision to offer OPS. Further study and longer-term follow-up is warranted to understand the trends in need for additional imaging, biopsy, and additional procedures following OPS.

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Affiliations

  1. Department of General, Thoracic and Vascular Surgery, Virginia Mason Medical Center, Seattle, WA, USA

    Angelena Crown MD, Ruby Laskin MD, Christina Weed MD, MPH & Flavio G. Rocha MD

  2. Breast Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Angelena Crown MD

  3. Margie Peterson Breast Center, John Wayne Cancer Institute, Providence Saint Johns Health Center, Santa Monica, CA, USA

    Janie Grumley MD

Authors
  1. Angelena Crown MD
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  2. Ruby Laskin MD
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  3. Christina Weed MD, MPH
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  4. Flavio G. Rocha MD
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  5. Janie Grumley MD
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Corresponding author

Correspondence to Janie Grumley MD.

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Angelena Crown, Ruby Laskin, Christina Weed, Flavio G. Rocha, and Janie Grumley declare no conflicts of interest.

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Crown, A., Laskin, R., Weed, C. et al. Evaluating Need for Additional Imaging and Biopsy After Oncoplastic Breast-Conserving Surgery. Ann Surg Oncol 27, 3650–3656 (2020). https://doi.org/10.1245/s10434-020-08500-y

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  • DOI: https://doi.org/10.1245/s10434-020-08500-y