Comparative Analysis of Postoperative Complications and Outcomes Between Oncoplastic and Conventional Breast-Conserving Surgery in Iranian Females

Abstract Breast cancer continues to be a global health burden, with over 2.25 million new cases diagnosed annually. Surgical management has shifted from radical mastectomy to breast-conserving surgeries, with oncoplastic breast-conserving surgery gaining prominence for its ability to combine oncological safety with aesthetic outcomes. This study compares the postoperative complications and outcomes between oncoplastic and conventional breast-conserving surgery in a cohort of Iranian women. This case series analysis was conducted at Imam Khomeini Hospital in Sari, Iran, between January 2019 and December 2023. A total of 150 female patients diagnosed with early-stage breast cancer were enrolled including 92 patients undergoing oncoplastic breast-conserving surgery and 58 undergoing conventional breast-conserving surgery. Data on demographics, tumor characteristics, surgery details, and postoperative complications were collected and analyzed. The primary outcome was the incidence of early postoperative complications including hematomas, seromas, and infections and late includes fat necrosis. The study found that oncoplastic breast-conserving surgery patients were more likely to have larger breast sizes and asymmetry than those in the conventional breast-conserving surgery group. Oncoplastic breast-conserving surgery involved the excision of larger tissue volumes. Postoperatively, oncoplastic breast-conserving surgery patients had significantly higher rates of fat necrosis (57.6% vs. 25.9%, p < 0.001) rates of hematomas (19.6% vs. 8.6%), and seromas (18.5% vs. 8.6%). No significant differences were observed for infections or nipple-areola deviation. Oncoplastic breast-conserving surgery offers superior aesthetic outcomes by allowing larger tissue resections and addressing complex anatomical challenges. However, it is associated with a higher incidence of fat necrosis, hematomas, and seromas compared to conventional surgery.