A comparison of oncological results of patients who have breast conserving surgery and subcutaneous mastectomy with immediate breast reconstruction in the surgical treatment of breast cancer

Objective: Breast cancer is one of the leading causes of mortality and morbidity in women. Even after the oncological cure is provided by surgical treatment, inadequate aesthetic results can adversely affect the life of the patients. New treatment modalities that provide better results in terms of aesthetics and provide oncological cure are preferred more frequently in the near future. This study aims to compare the oncological results of patients who underwent breast-conserving surgery (BCS) and subcutaneous mastectomy with immediate breast reconstruction surgery (SM), which are aesthetically acceptable methods in patients with breast cancer. Methods: The pathology and follow-up data of 1231 patients who underwent BCS or SM surgeries for breast cancer between January 2007 and January 2021 in our center were obtained. Results: The 5- and 10-year of overall survival (OS) rate for BCS group was 93,7% and 89,1% respectively. For SM group the 5- and 10- year of OS rate was 97,1% and 97,1% respectively. In multivariate analysis, being over 60 years old (HR: 3.21 95% Confidence Interval(CI):1.64-6.30 p=0.001), presence of comorbidity (HR: 1.71 95% CI:1.18-2.50 p=0.005), neoadjuvant chemotherapy (HR: 2.46 95% CI:1.40-4.35 p=0.002), pathological grade 3 (HR: 2.10 95% CI:1.11-3.95 p=0.021) , local recurrence (HR: 3.90 95% CI: 1.79-8.49 p=0.001) and distant metastasis (HR: 5.74 95% CI: 3.79-8.68 p<0.001) were seen as significant factors for OS. No significant difference was observed in disease free survival and OS between BCS and SM groups. Conclusion: In our single-center study, the follow-up data of 1231 patients with an average of 87.3 months showed that; SM is an oncologically safe options that can be applied to patients with a plan of BCS.