Moulding Breasts, Shaping Lives: Propagating Oncoplastic Surgery.

Abstract

The landscape of breast cancer surgery has journeyed a well-trodden path, transitioning from radical approaches to conservatism and ultimately finding a balance in rationalized radical conservatism. This evolution signifies a significant paradigm shift in breast cancer management. At its core, the concept of breast conservation gained renewed momentum with the emergence of oncoplasty. We, in this article, attempt to elaborate on the factors which led to the evolution of oncoplastic surgery as a mainstay surgical procedure for breast cancer in a tertiary cancer centre in Kerala, India. This will help centres to incorporate our strategies and thus popularize the concept of oncoplastic breast surgery in their clinical practice. 1.To ascertain the breast conservation rate and audit the various types of oncoplastic procedures done at our centre. A retrospective analysis of the prospective database of patients who underwent breast cancer surgery in a tertiary cancer centre in India over a period of 6 years from July 2017 to July 2023 was carried out. A total of 3036 breast surgeries were performed in total during the period including curative and palliative resections among which 2850 were curative resections including 1980 breast conservation surgeries and 870 mastectomies with a breast conservation rate of 69.5% (58-85%). The mean age of patients was 52.2 years with 58% in the post-menopausal age. Among the BCS, there were 1158 (Level I), 593 (Level II) and 199 (Level III) oncoplasties performed respectively. Thirty patients required additional volume replacement techniques in the form of pedicled TRAM (14/30), L.D flaps (12/30) and implants (4/30). Popularizing breast oncoplasty in a tertiary cancer centre in our state was a concerted effort with a combination of proper patient counseling, departmental training and regular ongoing conferences and workshops.