Pushing the Boundaries for Centrally Located Breast Tumors in Oncoplastic Breast Surgery: A Single Centre Audit

Background Breast Conservative Surgery (BCS) was considered a contraindication for centrally located breast tumor (CLBT), with mastectomy being the preferred treatment. However, advances in oncoplastic techniques now offer promising alternatives by facilitating wider surgical margins and enhancing cosmetic outcomes. This study aims to evaluate surgical, oncological, aesthetic outcome and quality of life (QoL) of oncoplastic breast surgery (OBS) for CLBT. Material and Methods In this study, 136 patients with CLBT were treated with various oncoplastic techniques including Level I (Grisotti Flap), Level II (Therapeutic Mammoplasty), and Level III (Perforator Flap) techniques. Surgical approach selection was guided by breast-size and degree of ptosis. Oncological and cosmetic outcomes were evaluated by surgeons post-operatively. Results The mean age of the patient was 52.7 years (range: 22-79). The Level I oncoplasty technique was utilised in 7 patients (11.7%); Level II (Therapeutic Mammoplasty) oncoplasty in 57 patients (41.9%) and Level 3 (Perforator Flaps) in 52 patients (38.2%). 13.9% of post-operative complications were observed. Cosmetic score revealed good to excellent outcomes regarding the patients’ satisfaction toward the surgical procedure. The study observed low rate of local recurrence (4.4%), distant recurrence (5.8%) and metastasis (5.8%). Mortality was 3.6% while all survival (OS) and disease-free survival (DFS) were high at 93.82% and 90.6%, respectively demonstrate the effectiveness of the surgical and adjuvant therapy employed. Discussion OBS offer viable and effective approach for managing CLBT. These procedures not only achieve satisfactory aesthetic results, but also ensure oncological safety, making them a promising alternate to mastectomy for CLBT.