Extreme Oncoplastic Surgery for Conservation of Breast in Locally Advanced, Multifocal and Multicentric Breast Cancer

Introduction: For individuals with locally advanced, multi-focal or multi-centric breast cancer (MFMC), extremeoncoplastic breast conservation surgery (EOBCS) may be a possibility. By improving esthetic results and oncologicalsafety, Extreme Oncoplasty (EO) expands the indications of breast conservative surgery (BCS) for patients whowould otherwise need mastectomy.Aim of work: To study the feasibility of extreme oncoplastic surgery for conservation of breast in locally advancedmultifocal and multicentric breast courser.Patients and methods: The study is prospective and retrospective, and comprised 40 patients who presented toMenoufia University Hospitals between 2020 and 2024 with tumors ≥ 50 mm or who had MF/MC in two adjacentquadrants. Therapeutic Reduction Mammoplasty (TRM) with immediate or delayed contralateral symmetry wasprovided to patients with big ptotic breasts (cup D). Lateral mammaplasty procedures were offered to patients withmedium-sized breasts (cup B, C) with the same tumor criteria.Results: Forty patients were included in the study with a median age of 55 years (range 37-70). Clear marginswere achieved in 39 (97.5%) patients, 1 (2.5%) patient showed inadequate margins at final histopathologyanalysis and required a completion mastectomy. None of participants got major complications. Minor complicationsas delayed healing of wound (17.5%), wound infection and dehiscence that required antibiotics (7.5%), seroma(7.5%), all managed conservatively. Regarding score of satisfaction, were (excellent) in 17 cases (42.5%), (good)in 21 cases (52.5%), and (fair) in 2 cases (5%).Conclusion: For patients with breast cancer whose tumors are ≥ 50 mm or MF/MC, extreme oncolastic surgeryis a good option with a low rate of complications and high patient satisfaction. So, it may be regarded as anoncologically safe alternative to mastectomy.