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Medline ® Abstract for Reference 94

of 'Breast conserving therapy'

Breast-conserving therapy for centrally located breast cancer.
Fitzal F, Mittlboeck M, Trischler H, Krois W, Nehrer G, Deutinger M, Jakesz R, Gnant M
Ann Surg. 2008;247(3):470.
OBJECTIVE: To analyze whether breast-conserving therapy (BCT) may be an oncologically safe approach and result in a good cosmesis in patients with centrally located breast cancer (CLBC).
SUMMARY BACKGROUND DATA: Only underpowered, retrospective, single-arm studies have suggested that oncoplastic BCT for CLBC may be oncologically safe and may result in a good cosmesis.
METHODS: The authors retrospectively analyzed the overall and recurrence-free survival in 1485 patients with breast cancer undergoing BCT comparing CLBC with non-CLBC. Moreover, the authors described 4 different oncoplastic techniques for BCT in patients with CLBC and compared the cosmetic results with simple lumpectomy according to a recently elaborated objective cosmetic evaluation system, the Breast Symmetry Index.
RESULTS: Kaplan-Meier curves show no significant difference in a 5-year overall, local, or distant recurrence-free survival between patients with CLBC and non-CLBC after BCT (94% vs. 96%; 100% vs. 98%; 92% vs. 90%; median follow-up, 35.3 months). The cosmetic outcome after oncoplastic BCT compared with simple lumpectomy differed significantly (Breast Symmetry Index: 22 +/- 6%d vs. 44 +/- 12%d; P<0.05).
CONCLUSIONS: The results demonstrate that BCT for CLBC is oncologically safe and that oncoplastic techniques improve cosmesis.
Department of Surgery, Medical University of Vienna, Austria. florian.fitzal@meduniwien.ac.at