Review Article| Volume 50, ISSUE 2, P211-221, April 2023

Modern Approaches to Oncoplastic Surgical Treatment

Published:January 02, 2023DOI:


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribers receive full online access to your subscription and archive of back issues up to and including 2002.

      Content published before 2002 is available via pay-per-view purchase only.


      Subscribe to Clinics in Plastic Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Kelsall J.E.
        • McCulley S.J.
        • Brock L.
        • et al.
        Comparing oncoplastic breast conserving surgery with mastectomy and immediate breast reconstruction: case-matched patient reported outcomes.
        J Plast Reconstr Aesthet Surg. 2017; 70: 1377-1385
        • Audretsch W.P.
        • Rezai M.
        • Kolotas C.
        • et al.
        Tumor-specific immediate reconstruction in breast cancer patients.
        Semin Plast Surg. 1998; 11: 71-100
        • Jonczyk M.M.
        • Jean J.
        • Graham R.
        • et al.
        Surgical trends in breast cancer: a rise in novel operative treatment options over a 12 year analysis.
        Breast Cancer Res Treat. 2019; 173: 267-274
        • Hernanz F.
        • González-Noriega M.
        • Sánchez S.
        • et al.
        Oncoplastic breast conserving surgery with tailored needle-guided excision.
        Gland Surg. 2017; 6: 698-705
        • Macmillan R.D.
        • McCulley S.J.
        Oncoplastic breast surgery: what, when and for whom?.
        Curr Breast Cancer Rep. 2016; 8: 112-117
        • Chatterjee A.
        • Gass J.
        • Patel K.
        • et al.
        A consensus Definition and classification system of oncoplastic surgery developed by the American society of breast surgeons.
        Ann Surg Oncol. 2019; 26: 3436-3444
        • Radtke C.
        Standards in oncoplastic breast reconstruction.
        Breast Care Basel Switz. 2019; 14: 269-270
        • Weber W.P.
        • Haug M.
        • Kurzeder C.
        • et al.
        Oncoplastic Breast Consortium consensus conference on nipple-sparing mastectomy.
        Breast Cancer Res Treat. 2018; 172: 523-537
        • Clough K.B.
        • Kaufman G.J.
        • Nos C.
        • et al.
        Improving breast cancer surgery: a classification and quadrant per quadrant atlas for oncoplastic surgery.
        Ann Surg Oncol. 2010; 17: 1375-1391
        • Losken A.
        • Brown C.A.
        How to optimize aesthetics for the partial mastectomy patient.
        Aesthet Surg J. 2020; 40: S55-S65
        • Kelemen P.
        • Pukancsik D.
        • Újhelyi M.
        • et al.
        Comparison of clinicopathologic, cosmetic and quality of life outcomes in 700 oncoplastic and conventional breast-conserving surgery cases: a single-centre retrospective study.
        Eur J Surg Oncol. 2019; 45: 118-124
        • Losken A.
        • Hart A.M.
        • Broecker J.S.
        • et al.
        Oncoplastic breast reduction technique and outcomes: an evolution over 20 years.
        Plast Reconstr Surg. 2017; 139: 824e-833e
        • Losken A.
        • Hart A.M.
        • Dutton J.W.
        • et al.
        The expanded use of autoaugmentation techniques in oncoplastic breast surgery.
        Plast Reconstr Surg. 2018; 141: 10-19
        • Haloua M.H.
        • Krekel N.M.A.
        • Winters H.A.H.
        • et al.
        A systematic review of oncoplastic breast-conserving surgery: current weaknesses and future prospects.
        Ann Surg. 2013; 257: 609-620
        • Papanikolaou I.G.
        • Dimitrakakis C.
        • Zagouri F.
        • et al.
        Paving the way for changing perceptions in breast surgery: a systematic literature review focused on oncological and aesthetic outcomes of oncoplastic surgery for breast cancer.
        Breast Cancer Tokyo Jpn. 2019; 26: 416-427
        • Chan S.W.W.
        • Cheung P.S.Y.
        • Chueng P.S.Y.
        • et al.
        Cosmetic outcome and percentage of breast volume excision in oncoplastic breast conserving surgery.
        World J Surg. 2010; 34: 1447-1452
        • Clough K.B.
        • Lewis J.S.
        • Couturaud B.
        • et al.
        Oncoplastic techniques allow extensive resections for breast-conserving therapy of breast carcinomas.
        Ann Surg. 2003; 237: 26-34
        • Hernanz F.
        • Regaño S.
        • Redondo-Figuero C.
        • et al.
        Oncoplastic breast-conserving surgery: analysis of quadrantectomy and immediate reconstruction with latissimus dorsi flap.
        World J Surg. 2007; 31: 1934-1940
        • Woerdeman L.A.E.
        • Hage J.J.
        • Thio E.A.
        • et al.
        Breast-conserving therapy in patients with a relatively large (T2 or T3) breast cancer: long-term local control and cosmetic outcome of a feasibility study.
        Plast Reconstr Surg. 2004; 113: 1607-1616
        • Veiga D.F.
        • Veiga-Filho J.
        • Ribeiro L.M.
        • et al.
        Evaluations of aesthetic outcomes of oncoplastic surgery by surgeons of different gender and specialty: a prospective controlled study.
        Breast Edinb Scotl. 2011; 20: 407-412
        • Gendy R.K.
        • Able J.A.
        • Rainsbury R.M.
        Impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery.
        Br J Surg. 2003; 90: 433-439
        • Darby S.
        • McGale P.
        • Correa C.
        • et al.
        • Early Breast Cancer Trialists’ Collaborative Group (EBCTCG)
        Effect of radiotherapy after breast-conserving surgery on 10-year recurrence and 15-year breast cancer death: meta-analysis of individual patient data for 10,801 women in 17 randomised trials.
        Lancet Lond Engl. 2011; 378: 1707-1716
        • Beddok A.
        • Kirova Y.
        • Laki F.
        • et al.
        The place of the boost in the breast cancer treatment: state of art.
        Radiother Oncol J Eur Soc Ther Radiol Oncol. 2022; 170: 55-63
        • Chua B.H.
        • Link E.K.
        • Kunkler I.H.
        • et al.
        Radiation doses and fractionation schedules in non-low-risk ductal carcinoma in situ in the breast (BIG 3-07/TROG 07.01): a randomised, factorial, multicentre, open-label, phase 3 study.
        Lancet Lond Engl. 2022; 400: 431-440
        • Kelemen G.
        • Varga Z.
        • Lázár G.
        • et al.
        Cosmetic outcome 1-5 years after breast conservative surgery, irradiation and systemic therapy.
        Pathol Oncol Res POR. 2012; 18: 421-427
        • Gladwish A.
        • Didiodato G.
        • Conway J.
        • et al.
        Implications of oncoplastic breast surgery on radiation boost delivery in localized breast cancer.
        Cureus. 2021; 13: e20003
        • Furet E.
        • Peurien D.
        • Fournier-Bidoz N.
        • et al.
        Plastic surgery for breast conservation therapy: how to define the volume of the tumor bed for the boost?.
        Eur J Surg Oncol. 2014; 40: 830-834
        • Kaufman C.S.
        • Cross M.J.
        • Barone J.L.
        • et al.
        A three-dimensional bioabsorbable tissue marker for volume replacement and radiation planning: a multicenter study of surgical and patient-reported outcomes for 818 patients with breast cancer.
        Ann Surg Oncol. 2021; 28: 2529-2542
        • Yehia Z.A.
        • Yoon J.
        • Sayan M.
        • et al.
        Does the use of BioZorb® result in smaller breast seroma volume?.
        Anticancer Res. 2022; 42: 2961-2965
        • Laplana M.
        • García-Marqueta M.
        • Sánchez-Fernández J.J.
        • et al.
        Effectiveness and safety of intraoperative radiotherapy (IORT) with low-energy X-rays (INTRABEAM®) for accelerated partial breast irradiation (APBI).
        Clin Transl Oncol Off Publ Fed Span Oncol Soc Natl Cancer Inst Mex. 2022; 24: 1732-1743
        • Cozzi S.
        • Augugliaro M.
        • Ciammella P.
        • et al.
        The role of interstitial brachytherapy for breast cancer treatment: an overview of indications, applications, and technical notes.
        Cancers. 2022; 14: 2564
        • Small W.
        • Refaat T.
        • Feldman S.M.
        • et al.
        Risk-stratified intraoperative radiation therapy as a definitive adjuvant radiation therapy modality for women with early breast cancer.
        Pract Radiat Oncol. 2022; 12: 320-323
        • Cracco S.
        • Semprini G.
        • Cattin F.
        • et al.
        Impact of intraoperative radiotherapy on cosmetic outcome and complications after oncoplastic breast surgery.
        Breast J. 2015; 21: 285-290
        • Allen S.G.
        • Speers C.
        • Jagsi R.
        Tailoring the omission of radiotherapy for early-stage breast cancer based on tumor biology.
        Semin Radiat Oncol. 2022; 32: 198-206
        • Knowlton C.A.
        • Jimenez R.B.
        • Moran M.S.
        Risk assessment in the molecular era.
        Semin Radiat Oncol. 2022; 32: 189-197
        • De La Cruz L.
        • Blankenship S.A.
        • Chatterjee A.
        • et al.
        Outcomes after oncoplastic breast-conserving surgery in breast cancer patients: a systematic literature review.
        Ann Surg Oncol. 2016; 23: 3247-3258
        • Losken A.
        • Dugal C.S.
        • Styblo T.M.
        • et al.
        A meta-analysis comparing breast conservation therapy alone to the oncoplastic technique.
        Ann Plast Surg. 2014; 72: 145-149
        • Piper M.L.
        • Esserman L.J.
        • Sbitany H.
        • et al.
        Outcomes following oncoplastic reduction mammoplasty: a systematic review.
        Ann Plast Surg. 2016; 76: S222-S226
        • Fitoussi A.D.
        • Berry M.G.
        • Famà F.
        • et al.
        Oncoplastic breast surgery for cancer: analysis of 540 consecutive cases [outcomes article].
        Plast Reconstr Surg. 2010; 125: 454-462
        • Cil T.D.
        • Cordeiro E.
        Complications of oncoplastic breast surgery involving soft tissue transfer versus breast-conserving surgery: an analysis of the NSQIP database.
        Ann Surg Oncol. 2016; 23: 3266-3271
        • Bloom J.A.
        • Asban A.
        • Tian T.
        • et al.
        A cost-utility analysis comparing immediate oncoplastic surgery with delayed oncoplastic surgery in smoking breast cancer patients.
        Ann Surg Oncol. 2021; 28: 2579-2588
        • Bloom J.A.
        • Rashad R.
        • Chatterjee A.
        The impact on mortality and societal costs from smoking cessation in aesthetic plastic surgery in the United States.
        Aesthet Surg J. 2019; 39: 439-444
        • Kapadia S.M.
        • Reitz A.
        • Hart A.
        • et al.
        Time to radiation after oncoplastic reduction.
        Ann Plast Surg. 2019; 82: 15-18
        • Hillberg N.S.
        • Meesters-Caberg M.A.J.
        • Beugels J.
        • et al.
        Delay of adjuvant radiotherapy due to postoperative complications after oncoplastic breast conserving surgery.
        Breast Edinb Scotl. 2018; 39: 110-116
        • Deigni O.A.
        • Baumann D.P.
        • Adamson K.A.
        • et al.
        Immediate contralateral mastopexy/breast reduction for symmetry can Be performed safely in oncoplastic breast-conserving surgery.
        Plast Reconstr Surg. 2020; 145: 1134-1142
        • Khan J.
        • Kahn J.
        • Barrett S.
        • et al.
        Oncoplastic breast conservation does not lead to a delay in the commencement of adjuvant chemotherapy in breast cancer patients.
        Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 2013; 39: 887-891
        • Fitzal F.
        • Bolliger M.
        • Dunkler D.
        • et al.
        Retrospective, multicenter analysis comparing conventional with oncoplastic breast conserving surgery: oncological and surgical outcomes in women with high-risk breast cancer from the OPBC-01/iTOP2 study.
        Ann Surg Oncol. 2022; 29: 1061-1070
        • Barellini L.
        • Marcasciano M.
        • Lo Torto F.
        • et al.
        Intraoperative ultrasound and oncoplastic combined approach: an additional tool for the oncoplastic surgeon to obtain tumor-free margins in breast conservative surgery-A 2-year single-center prospective study.
        Clin Breast Cancer. 2020; 20: e290-e294
        • Niinikoski L.
        • Leidenius M.H.K.
        • Vaara P.
        • et al.
        Resection margins and local recurrences in breast cancer: comparison between conventional and oncoplastic breast conserving surgery.
        Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 2019; 45: 976-982
        • Losken A.
        • Smearman E.L.
        • Hart A.M.
        • et al.
        The impact oncoplastic reduction has on long-term recurrence in breast conservation therapy.
        Plast Reconstr Surg. 2022; 149: 867e-875e
        • Pearce B.C.S.
        • Fiddes R.N.
        • Paramanathan N.
        • et al.
        Extreme oncoplastic conservation is a safe new alternative to mastectomy.
        Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 2020; 46: 71-76
        • De Lorenzi F.
        • Loschi P.
        • Bagnardi V.
        • et al.
        Oncoplastic breast-conserving surgery for tumors larger than 2 centimeters: is it oncologically safe? A matched-cohort analysis.
        Ann Surg Oncol. 2016; 23: 1852-1859
        • Chauhan A.
        • Sharma M.M.
        Evaluation of surgical outcomes following oncoplastic breast surgery in early breast cancer and comparison with conventional breast conservation surgery.
        Med J Armed Forces India. 2016; 72: 12-18
        • Song H.M.
        • Styblo T.M.
        • Carlson G.W.
        • et al.
        The use of oncoplastic reduction techniques to reconstruct partial mastectomy defects in women with ductal carcinoma in situ.
        Breast J. 2010; 16: 141-146
        • Broecker J.S.
        • Hart A.M.
        • Styblo T.M.
        • et al.
        Neoadjuvant therapy combined with oncoplastic reduction for high-stage breast cancer patients.
        Ann Plast Surg. 2017; 78: S258-S262
        • Koppiker C.B.
        • Noor A.U.
        • Dixit S.
        • et al.
        Extreme oncoplastic surgery for multifocal/multicentric and locally advanced breast cancer.
        Int J Breast Cancer. 2019; 2019: 4262589
        • Rose M.
        • Svensson H.
        • Handler J.
        • et al.
        Patient-reported outcome after oncoplastic breast surgery compared with conventional breast-conserving surgery in breast cancer.
        Breast Cancer Res Treat. 2020; 180: 247-256
        • Bazzarelli A.
        • Baker L.
        • Petrcich W.
        • et al.
        Patient satisfaction following level II oncoplastic breast surgery: a comparison with mastectomy utililizing the breast-Q questionnaire will be published in surgical oncology.
        Surg Oncol. 2020; 35: 556-559
        • Chand N.D.
        • Browne V.
        • Paramanathan N.
        • et al.
        Patient-reported outcomes are better after oncoplastic breast conservation than after mastectomy and autologous reconstruction.
        Plast Reconstr Surg Glob Open. 2017; 5: e1419
        • Hart A.M.
        • Pinell-White X.
        • Egro F.M.
        • et al.
        The psychosexual impact of partial and total breast reconstruction: a prospective one-year longitudinal study.
        Ann Plast Surg. 2015; 75: 281-286
        • Char S.
        • Bloom J.A.
        • Erlichman Z.
        • et al.
        A comprehensive literature review of patient-reported outcome measures (PROMs) among common breast reconstruction options: what types of breast reconstruction score well?.
        Breast J. 2021; 27: 322-329
        • Gardfjell A.
        • Dahlbäck C.
        • Åhsberg K.
        Patient satisfaction after unilateral oncoplastic volume displacement surgery for breast cancer, evaluated with the BREAST-QTM.
        World J Surg Oncol. 2019; 17: 96
        • Kim K.D.
        • Kim Z.
        • Kuk J.C.
        • et al.
        Long-term results of oncoplastic breast surgery with latissimus dorsi flap reconstruction: a pilot study of the objective cosmetic results and patient reported outcome.
        Ann Surg Treat Res. 2016; 90: 117-123
        • van Paridon M.W.
        • Kamali P.
        • Paul M.A.
        • et al.
        Oncoplastic breast surgery: achieving oncological and aesthetic outcomes.
        J Surg Oncol. 2017; 116: 195-202
        • Rezai M.
        • Kraemer S.
        • Kimmig R.
        • et al.
        Breast conservative surgery and local recurrence.
        Breast Edinb Scotl. 2015; 24: S100-S107
        • Ojala K.
        • Meretoja T.J.
        • Leidenius M.H.K.
        Aesthetic and functional outcome after breast conserving surgery - comparison between conventional and oncoplastic resection.
        Eur J Surg Oncol J Eur Soc Surg Oncol Br Assoc Surg Oncol. 2017; 43: 658-664