Author/Authors :
Koppiker, Chaitanyanand B. Orchids Breast Health Clinic - Prashanti Cancer Care Mission, 1&2 - Kapilavastu - Senapati Bapat Road - Pune - Maharashtra 411016, India , Ul Noor, Aijaz Orchids Breast Health Clinic - Prashanti Cancer Care Mission, 1&2 - Kapilavastu - Senapati Bapat Road - Pune - Maharashtra 411016, India , Dixit, Santosh Orchids Breast Health Clinic - Prashanti Cancer Care Mission, 1&2 - Kapilavastu - Senapati Bapat Road - Pune - Maharashtra 411016, India , Busheri, Laleh Orchids Breast Health Clinic - Prashanti Cancer Care Mission, 1&2 - Kapilavastu - Senapati Bapat Road - Pune - Maharashtra 411016, India , Sharan, Gautam Department of Radiation Oncology - Inlaks and Budhrani Hospital - Pune 411001, India , Dhar, Upendra Orchids Breast Health Clinic - Prashanti Cancer Care Mission, 1&2 - Kapilavastu - Senapati Bapat Road - Pune - Maharashtra 411016, India , Allampati, Hari Kiran Ruby Hall Clinic - Pune - Maharashtra 411040, India , Nare, Smeeta Orchids Breast Health Clinic - Prashanti Cancer Care Mission, 1&2 - Kapilavastu - Senapati Bapat Road - Pune - Maharashtra 411016, India
Abstract :
Introduction. Breast conserving surgery (BCS) followed by radiation therapy (RT) has become the preferred alternative to
mastectomy for patients with early stage breast cancer (BC). Randomized trials have confrmed equivalent locoregional control
and overall survival for BCS and mastectomy. Extreme Oncoplasty (EO) extends the indications of BCS for patients who
would otherwise require mastectomy, ensuring better aesthetic outcomes and oncological safety. Methods. BC patients with
multifocal/multicentric (MF/MC) tumors, extensive DCIS, or large tumor >50mm underwent EO at our breast unit. Terapeutic
reduction mammaplasty (TRM) with wise pattern preoperative markings and dual pedicle technique involving parenchymal
rearrangement was used for oncoplastic reconstructions in majority of the cases followed by RT. Patient reported outcome measures
(PROMs) were assessed using the validated Breast-Q questionnaire. Results. Of the 39 patients in the study, 36 had unilateral and
3 had bilateral BC. Mean age was 47.2 years. Median tumor size was 75mm. 17 (43.6%) patients received NACT; none achieved a
complete clinical response. 28 (71.8%) patients were administered to adjuvant chemotherapy. 33(84.6%) patients received RT to the
breast with a median dose of 50Gy in 28 fractions and a boost dose of 10Gy in 5 fractions to the tumor bed. No major complications
or local recurrences were observed. Excellent Breast-Q scores were observed in patients undergoing EO afer 12 months of follow-up.
Conclusion. EO followed by RT results in acceptable local-regional control, low rate of complications, and high patient satisfaction.
In selected patients, EO could provide a safe alternative for breast conservation surgery instead of mastectomy.
