Patient-Reported Impact of Oncoplastic Breast Conservation Compared to Mastectomy with Reconstruction: A Systematic Review

Background: Given the oncologic safety and clinical benefits of oncoplastic breast conservation surgery (O-BCS), we conducted a systematic review to evaluate patient-reported outcomes, including breast satisfaction and physical, psychosocial, and sexual well-being in those undergoing O-BCS compared to mastectomy and reconstruction (M-R). This study aimed to inform clinical decision-making for patients with breast cancer not suitable for standard breast conservation. Methods: According to PRISMA Guidelines, we identified studies from MEDLINE, Embase, PubMed, and Google Scholar. Studies were included where they compared patient-reported outcomes between O-BCS and M-R using a validated assessment tool such as the BREAST-Q questionnaire. The quality of studies was appraised using the Newcastle-Ottawa Scale (NOS). Results: Out of the 3434 citations identified by our search, a total of 11 studies were deemed suitable for inclusion, and 9 studies used the validated BREAST-Q assessment tool. There were a total of 1808 O-BCS and 1413 M-R patients. All studies showed improved or equivalent breast satisfaction, psychosocial well-being, and sexual well-being after O-BCS. Physical well-being was reported to be superior in the M-R group. The findings are limited by the moderate to high risk of bias, heterogeneity, variation in outcome measures, differing follow-up durations, and differences in adjustment. Conclusion: Given the potentially positive impact on patient-reported outcomes, where indicated and feasible, oncoplastic breast-conserving surgery should be offered as a valid surgical alternative to mastectomy and reconstruction as part of a patient-centered individualized treatment approach for breast cancer.