Oncoplastic approach to excisional breast biopsies

Oncoplastic breast surgery is a common surgical procedure that relies on reshaping the remaining breast tissue after resection in patients with a known diagnosis of malignancy. Reportedly, cosmetic efficacy and oncologic success in breast cancer treatment are likely to be achieved simultaneously by many oncoplastic procedures. Here in this study, these procedures are adapted to the surgical diagnosis of breast cancer and oncologic outcomes with the aesthetic success of these methods were investigated, using a prospective randomized clinical trial design comparing conventional excisional biopsy with the oncoplastic approach. During the preliminary phase of the study, literature was reviewed to establish an evidence-based oncoplastic approach to excisional breast biopsies, oncapex protocol, for different breast and lesion characteristics of patients who are decided to be suitable for excisional breast biopsy. Specifically, selected procedures varying according to the breast size and lesion site, were tabulated in the bilevel oncoplastic protocol determined by calculating the anticipated volume ratio of the resection specimen. Since it is known that different cosmetic results reported for different segment lesions, breast tissue is divided into 3 blocks with 2 sagittal planes; medial, central and lateral blocks. Central and lateral blocks yielded better cosmetic results (p<0.05). Involvement of surgical margins were compared with the intention of promoting better local management. However, it was understood that there was no statistical difference between the two groups (p>0,05). All the pathology reports and radiology were reviewed to identify discordance for all lesions and the complete diagnostic process is scrutinized to expose any unnecessary biopsies. Potential implications of advanced non-invasive biopsy methods on the clinical course of detectable lesions are discussed. If supported by future large-scale studies, this approach is likely to revolutionize breast cancer diagnosis and oncapex biopsy could be the new gold standart diagnostic method.