Journal: Scientific reports
This systematic review and meta-analysis compared volume displacement (VD) and volume replacement (VR) oncoplastic breast-conserving techniques with respect to oncologic safety, complications, and satisfaction.
Methods:
- Systematic search: PubMed, Embase, and Cochrane CENTRAL through November 2023.
- Inclusion criteria: Original studies reporting quantitative data on satisfaction, local recurrence, re-excision, margin status, and key complications (hematoma, seroma, wound infection, fat necrosis).
- Study selection: From 17,374 records, 80 studies were eligible; 46 contributed quantitative data.
Key findings:
- Oncologic safety: VD and VR techniques showed comparable outcomes, with similar local recurrence (pooled proportion 0.02; 95% CI 0.02–0.03) and re-excision rates (0.05; 95% CI 0.04–0.07).
- Complications: VR techniques were associated with a higher rate of fat necrosis (pooled proportion 0.07; 95% CI 0.04–0.12). Rates of other complications (hematoma, seroma, wound infection) were not highlighted as differing between techniques in the abstract.
- Satisfaction: Overall satisfaction after oncoplastic breast-conserving surgery was high (pooled proportion 0.83; 95% CI 0.78–0.87). VD techniques achieved the highest satisfaction levels (0.93; 95% CI 0.85–0.97).
Conclusion: Oncoplastic breast-conserving surgery appears to be a safe option for early-stage breast cancer, with low recurrence and re-excision rates and high patient satisfaction. VD and VR offer similar oncologic safety, but VR may carry a higher risk of fat necrosis, while VD may yield higher satisfaction rates.