Oncoplastic or Conventional Breast-Conserving Surgery? Outcomes from a West Java Retrospective Cohort Study
Year: 2025
Type: article
Study design: Observational Study
Abstract: Purpose: Breast-conserving surgery (BCS) followed by adjuvant radiotherapy is the standard treatment for early breast cancer in Indonesia. Our aim was to compare the outcomes of BCS with oncoplastic surgery (OPS), a less common method of breast cancer treatment in the country. Patients and Methods: This retrospective cohort study was conducted at Hasan Sadikin General Hospital, Bandung, West Java, Indonesia. Patients with biopsy-proven Stage I to II breast cancer who underwent either OPS or BCS between 1 July 2020 to 30 June 2023, were identified. Data were collected by reviewing patient files and electronic records. Results: A total of 82 patients were included in the study, with 43 (52.4%) undergoing BCS and 39 (47.6%) undergoing OPS. Age in OPS group 39.25 ± 4.9 was not significant difference compare with BCS group 39.86 ± 5.11. The mean tumor volume was higher in the OPS group (34.72 cm 3 ) compared to the BCS group (22.35 cm 3 ), and postoperative complications were also higher in the OPS group (7.6% vs 0%). Despite the use of frozen section analysis in the operating theatre, the frequency of positive margins was greater in the BCS group (9.3% vs 2.5%). There were no significant differences in the histologic type of tumor and immunohistochemistry between the two groups. Conclusion: OPS is a valid alternative approach to breast cancer treatment that can be offered to women with early stage breast cancer at complex locations owing to the reduced occurrence of positive margins and thus lowered re-excision rates. Plain Language Summary: This study compared two types of breast cancer surgery—standard breast-conserving surgery (BCS) and oncoplastic surgery (OPS)—among 82 women in Indonesia treated in the last five years. OPS combines tumor removal with plastic surgery techniques to improve cosmetic outcomes, especially for larger or more difficult-to-reach tumors. Of the 82 patients, 39 underwent OPS and 43 had BCS. Researchers looked at tumor size, whether cancer cells were left at the edges (margin positivity), and complications within 30 days after surgery. The average age of patients in both groups was around 39 years. OPS was more commonly chosen for larger tumors, and it resulted in fewer cases of positive margins— 2.5% in the OPS group compared to 9.3% in the BCS group—suggesting more complete tumor removal. Although OPS had a slightly higher rate of minor complications such as fluid buildup and fat necrosis, these were managed successfully without hospital readmission. Cosmetic outcomes were also better in the OPS group. OPS techniques varied based on tumor location, including flap reconstruction and breast reshaping methods. Despite its benefits, OPS is still new in Indonesia, and its wider use is limited by the need for specialized training and cultural factors that influence surgical choices. Nevertheless, the study concludes that OPS is a safe and effective alternative to standard BCS. It offers better cosmetic results and reduces the need for repeat surgery, making it a promising option for breast cancer treatment as surgical expertise continues to grow in the country. Keywords: breast cancer, breast conserving surgery, oncoplastic surgery
DOI: 10.2147/ijwh.s560836
Institutions: Dr. Hasan Sadikin General Hospital, Padjadjaran University
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,836
OpenAlex ID: W4417397665