Three-year outcomes of level II oncoplastic breast-conserving surgery: A comparative analysis

This study aimed to compare the clinical and patient-reported outcomes of level II oncoplastic breast-conserving surgery (BCS) versus conventional BCS in breast cancer treatment, focusing on re-excision rates, early postoperative complications, and quality of life (QoL). This retrospective cohort study included 395 patients who underwent either conventional BCS (n=255) or level II oncoplastic BCS (n=140) at a tertiary academic center between January 2021 and June 2024. Demographic, clinicopathological, surgical, and postoperative data were extracted from the institutional database. Patient-reported outcomes were assessed using BREAST-Q scores in a subset of patients. The mean age did not differ significantly between groups (p=0.13). Reexcision was required in 22% of the conventional BCS group and 5% of the oncoplastic BCS group (p20 mm and multifocal disease were independent predictors of re-excision, while oncoplastic BCS was protective (p<0.001). BREAST-Q scores for satisfaction with breasts, psychosocial well-being, and sexual well-being were significantly higher in the oncoplastic group (p<0.001). No significant differences were observed in pathological tumor size (p=0.45), ultrasound/MRI tumor size (p=0.62, p=0.35), seroma formation (p=0.72), or surgical site infection (p=0.23). Level II oncoplastic BCS was associated with significantly lower reexcision rates and improved patient-reported QoL compared to conventional BCS. These findings, supported by predictive modeling and QoL data, suggest that oncoplastic BCS is a preferable approach for balancing oncologic safety, aesthetic outcomes, and patient satisfaction.