From Radical Mastectomy to Breast-Conserving Therapy and Oncoplastic Breast Surgery: A Narrative Review Comparing Oncological Result, Cosmetic Outcome, Quality of Life, and Health Economy

Author:

Kaviani Ahmad12,Sodagari Nassim1,Sheikhbahaei Sara34,Eslami Vahid45,Hafezi-Nejad Nima367,Safavi Amin2,Noparast Maryam2,Fitoussi Alfred8

Affiliation:

1. Department of General Surgery, Tehran University of Medical Sciences (TUMS), P.O. Box 13145-158, Tehran, Iran

2. Kaviani Breast Disease Institute (KBDI), P.O. Box 14358-6443, Tehran, Iran

3. School of Medicine/Public Health, Tehran University of Medical Sciences (TUMS), P.O. Box 1416135, Tehran, Iran

4. Student’s Scientific Research Centre (SSRC), Tehran University of Medical Sciences (TUMS), P.O. Box 14155-6537, Tehran, Iran

5. Sina Trauma and Surgery Research Centre, Tehran University of Medical Sciences (TUMS), P.O. Box 11365-3876, Tehran, Iran

6. The Young Scholars Club, No. 8 West Niloofar Street, Africa (Jordan) Avenue, Tehran, Iran

7. Iran’s National Elite Foundation, No. 17 Haghighat Talab Street, Southern Nejatollahi Avenue, Tehran, Iran

8. Department of Surgery, Institute Curie, P.O. Box 75005, Paris, France

Abstract

Surgical management of breast cancer has evolved considerably over the last two decades. There has been a major shift toward less-invasive local treatments, from radical mastectomy to breast-conserving therapy (BCT) and oncoplastic breast surgery (OBS). In order to investigate the efficacy of each of the three abovementioned methods, a literature review was conducted for measurable outcomes including local recurrence, survival, cosmetic outcome, quality of life (QOL), and health economy. From the point of view of oncological result, there is no difference between mastectomy and BCT in local recurrence rate and survival. Long-term results for OBS are not available. The items assessed in the QOL sound a better score for OBS in comparison with mastectomy or BCT. OBS is also associated with a better cosmetic outcome. Although having low income seems to be associated with lower BCT and OBS utilization, prognosis of breast cancer is worse in these women as well. Thus, health economy is the matter that should be studied seriously. OBS is an innovative, progressive, and complicated subspeciality that lacks published randomized clinical trials comparing surgical techniques and objective measures of outcome, especially from oncologic and health economy points of view.

Publisher

Hindawi Limited

Subject

Pulmonary and Respiratory Medicine,Pediatrics, Perinatology, and Child Health

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