A Randomised Controlled Trial Evaluating the Aesthetic Outcomes of Oncoplasty vs. Simple Closure and 1- vs. 2-cm Excision Margin for Early Breast Cancer

Breast conservation surgery is the standard of care for patients with early breast cancer. Although most surgeons perform oncoplasty for closure of defect, there is no randomised evidence for its favour as compared to simple closure of breast defect. We compared the cosmetic outcomes of patients treated by oncoplasty versus simple closure with 1-cm vs. 2-cm margin of excision. One hundred and four patients with breast cancer were randomised to four groups: excision with 1-cm margin with simple closure or excision with 2-cm margin with simple closure; excision with 1-cm margin and oncoplasty; and excision with 2-cm margin oncoplasty. Fifty-two patients underwent oncoplasty and 52 patients had simple closure of breast defect. There was no significant difference in the cosmetic outcomes in patients undergoing oncoplasty compared to simple closure. Excision with 2-cm margin compared to 1 cm did not worsen the cosmetic outcome. The margin positivity and re-excision rates were higher with 1-cm margin and oncoplastic closure group (p-value 0.018). There was no significant difference in complications between oncoplasty compared to simple closure, and 1-cm vs. 2-cm margin of excision. Simple closure demonstrated similar cosmesis as compared to oncoplasty.