Clinical and patient-reported outcomes in oncoplastic breast conservation surgery from a single surgeon’s practice in a busy community hospital in Canada

BACKGROUND: Oncoplastic breast surgery aims to maintain quality of life by pre-empting and mitigating against breast asymmetry while not compromising oncological effectiveness. This case series demonstrates the implementation of an effective oncoplastic surgical practice in a community hospital within Canada and shows low rates of perioperative complications as well as high levels of patient-reported outcome measures. METHODS: A retrospective chart review of patients diagnosed with stage 0–3 breast cancer treated with level I and level II oncoplastic techniques by a single breast surgeon was undertaken. Patient, tumour, procedure, and outcome data were collected. Patient satisfaction was assessed with the Breast-Q questionnaire administered pre- and postoperatively. RESULTS: Oncoplastic breast conservation surgery was performed on 340 patients over a 31-month period. The average size of breast lesions was 1.8 cm, with 96 patients having lesions 2–5 cm in size and 10 patients having tumours larger than 5 cm. Thirty (8.8%) patients experienced a complication requiring intervention. The positive margin rate was 9.4%, and the completion mastectomy rate was 4.7%. Breast Q scores increased across breast satisfaction, process of care, psychosocial, physical, and sexual satisfaction domains postoperatively. CONCLUSION: This case series demonstrates the feasibility of an oncoplastic breast surgery practice in a busy community hospital in Canada. This adds to the growing body of North American data on the clinical and oncological safety of these techniques and introduces the idea of collecting patient-reported outcome measures within a Canadian population. We hope that this enables these techniques to become the standard of care in North America.