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Breast Cancer Res Treat. 2017 Aug;165(1):139-149. doi: 10.1007/s10549-017-4314-5. Epub 2017 Jun 3.

First international consensus conference on standardization of oncoplastic breast conserving surgery.

Author information

1
Breast Center, University Hospital Basel, Basel, Switzerland. walter.weber@usb.ch.
2
Breast Center, University Hospital Basel, Basel, Switzerland.
3
Memorial Sloan Kettering Cancer Center, New York, USA.
4
Breast Center St. Gallen, St. Gallen, Switzerland.
5
Breast-Center Zurich, Zurich, Switzerland.
6
Breast Center Hirslanden Clinics Aarau Cham Zug and frauenarztzentrum aargau ag, Baden, Switzerland.
7
Department of Obstetrics and Gynecology, Cantonal Hospital of Lucerne, Lucerne, Switzerland.
8
Division of Plastic, Reconstructive and Aesthetic Surgery, Ospedale Regionale di Lugano (ORL), Breast Centre of Switzerland (CSSI), Ente Ospedaliero Cantonale (EOC), Lugano, Switzerland.
9
Department of Surgery and Comprehensive Cancer Center Vienna, Medical University Vienna, Vienna, Austria.
10
Breast Center, Hirslanden Klinik St. Anna, Lucerne, Switzerland.
11
Department of Gynecology, Medical Univerisity Graz, Auenbruggerplatz 14, 8036, Graz, Austria.
12
Breast Center Salzburg, University Clinic Salzburg, Paracelsus Medical University Salzburg, Salzburg, Austria.
13
Plastische, Ästhetische und Rekonstruktive Chirurgie, Wilhelminenspital der Stadt, Vienna, Austria.
14
Universitäts-Brustzentrum, Universitäts-Frauenklinik, Im Neuenheimer Feld 440, Heidelberg, Germany.
15
Department of Women's Health, University Breast Center Tubingen, Tübingen, Germany.
16
Gynecology with Breast Center, Charité Universitätsmedizin Berlin, Berlin, Germany.
17
Breast Center, University Hospital Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.
18
Breast Center, University Hospital Frankfurt, Frankfurt, Germany.
19
Breast Center at the English Garden, Munich, Germany.
20
Breast Surgery Unit at the Department of Ob/Gyn, University Hospital Rostock, Suedring 81, 18059, Rostock, Germany.

Abstract

PURPOSE:

To obtain consensus recommendations for the standardization of oncoplastic breast conserving surgery (OPS) from an international panel of experts in breast surgery including delegates from the German, Austrian and Swiss societies of senology.

METHODS:

A total of 52 questions were addressed by electronic voting. The panel's recommendations were put into context with current evidence and the report was circled in an iterative open email process until consensus was obtained.

RESULTS:

The panelists considered OPS safe and effective for improving aesthetic outcomes and broadening the indication for breast conserving surgery (BCS) towards larger tumors. A slim majority believed that OPS reduces the rate of positive margins; however, there was consensus that OPS is associated with an increased risk of complications compared to conventional BCS. The panel strongly endorsed patient-reported outcomes measurement, and recommended selected scales of the Breast-Q™-Breast Conserving Therapy Module for that purpose. The Clough bi-level classification was recommended for standard use in clinical practice for indicating, planning and performing OPS, and the Hoffmann classification for surgical reports and billing purposes. Mastopexy and reduction mammoplasty were the only two recognized OPS procedure categories supported by a majority of the panel. Finally, the experts unanimously supported the statement that every OPS procedure should be tailored to each individual patient.

CONCLUSIONS:

When implemented into clinical practice, the panel recommendations may improve safety and effectiveness of OPS. The attendees agreed that there is a need for prospective multicenter studies to optimize patient selection and for standardized criteria to qualify and accredit OPS training centers.

KEYWORDS:

Breast cancer; Breast conserving surgery; Breast surgery; Oncoplastic surgery

PMID:
28578506
DOI:
10.1007/s10549-017-4314-5
[Indexed for MEDLINE]

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