The advantages of oncoplastic breast surgery (OBS) over traditional breast-conserving surgery (BCS) contribute to better aesthetic and oncological outcomes in breast cancer treatment, improving patients' quality of life.
Improvement of Aesthetic Outcomes
Oncoplastic surgical techniques provide significant aesthetic gains through glandular tissue mobilization, skin reduction, and symmetry surgeries. In comparisons of patient satisfaction in the literature, aesthetic scores were found to be significantly higher in patients who underwent oncoplastic surgery. For example, in multicenter studies such as the ORBIT study, over 80% of patients reported “good” or “excellent” cosmetic results with OMC.
Improving Quality of Life
Oncoplastic techniques not only improve cosmetic outcomes but also enhance psychosocial well-being. This is reflected in better outcomes in areas such as body image, perception of femininity, and depression-anxiety. In validated surveys such as BREAST-Q and EORTC QLQ-BR23, breast satisfaction, sexual life, and social functioning scores are significantly higher in OMC groups compared to BCS.
Reducing Reoperations Due to Positive Surgical Margins
Since oncoplastic techniques allow for a wider excision area, positive surgical margins are less common. Surgeons can be more relaxed because there is no aesthetic deformity despite the wide resection. This reduces the rates of re-excision or mastectomy. For example, meta-analyses report a positive margin rate of 6–10% in OMC, while in classical MKC, this rate can reach up to 15–20% (p < 0.01).
Reducing Local Recurrence Rates
Wider excision is one of the most important advantages of oncoplastic surgery and may be a factor in reducing the risk of local recurrence. High rates of negative surgical margins and more radical removal of the tumor bed have a positive effect on recurrence. In 5–10-year follow-up data, local recurrence rates between OMC and MKC have been reported to be similar or lower (e.g., OBC 3.7% vs. BCS 5.2%; p = 0.04).
Expanding the Indications for MKC in Large, Multifocal, or Multicentric Tumors
In some cases traditionally requiring mastectomy, a breast-conserving approach is now possible with oncoplastic surgery. Especially with glandular remodeling techniques, extensive resections can be performed from multiple foci while preserving breast integrity. This allows for the expansion of surgical indications and offers patients the opportunity to avoid mastectomy.
In conclusion, oncoplastic breast surgery is an approach that not only improves aesthetics but also increases oncological safety. When performed with the right patient selection, multidisciplinary planning, and experienced surgeons, it offers significant advantages over traditional mastectomy in terms of both quality of life and oncological outcomes. MKC should now be viewed not only as a cosmetic improvement but also as an oncological strategy that increases breast-conserving treatment rates.
