Extreme oncoplastiek versus mastectomie met prepectorale reconstructie: vergelijking van overleving en tevredenheid

INTRODUCTION: Breast-conserving surgery combined with radiotherapy is the standard treatment for early-stage breast cancer. The term extreme oncoplasty refers to conservative surgery in cases where most surgeons would recommend mastectomy. The objective of this study was to evaluate the safety of extreme oncoplasty and mastectomy with prepectoral reconstruction, in terms of oncologic safety, satisfaction, and quality of life. PATIENTS AND METHODS: A cross-sectional observational study comparing extreme oncoplasty with skin-sparing mastectomy and immediate prepectoral reconstruction. RESULTS: Patients who underwent mastectomy were significantly younger, had a lower body mass index, and 62.6% had undergone genetic testing. Patients who underwent extreme oncoplasty had larger tumours, and 46.9% were multicentric/multifocal tumours. There were no differences in asymmetries, and patients who had undergone mastectomy and reconstruction had a higher incidence of deformities. There were no significant differences in overall survival or locoregional recurrence. Women who underwent extreme oncoplasty were more satisfied with their breasts. CONCLUSIONS: Extreme oncoplasty and skin-sparing mastectomy with immediate reconstruction were safe techniques in terms of overall survival and local recurrence. Women who underwent extreme oncoplasty were highly satisfied with their breasts. The decision to use each technique should be discussed with the patient.