Evaluating oncoplastic breast-conserving surgery: oncological safety, risks, and satisfaction—a systematic review and meta-analysis

Oncoplastic breast-conserving surgery (OBCS) comprises diverse techniques aimed at enhancing aesthetic outcomes and safety in breast cancer treatment. However, a knowledge gap exists in understanding the comprehensive assessment of safety factors and satisfaction rates associated with OBCS techniques. This systematic review and meta-analysis aim to compare volume displacement (VD) and volume replacement (VR) techniques concerning oncological safety, complication rates and patient satisfaction. A systematic literature search was conducted in three databases-PubMed, Embase, and Cochrane Library (CENTRAL)-up to November 2023. Original articles with quantitative satisfaction rates, recurrence, re-excision, margin status, and complications (hematoma, seroma, wound infection, fat necrosis). The systematic search identified 17,374 records, with 80 eligible studies and 46 providing quantitative data. Results showed comparable oncological safety between VD and VR techniques, including similar recurrence (Prop: 0.02; CI 0.02-0.03) and re-excision rates (Prop: 0.05; CI 0.04-0.07). VR techniques had a higher incidence of fat necrosis (Prop: 0.07; CI 0.04-0.12). Overall satisfaction was high (Prop: 0.83; CI 0.78-0.87), with VD yielding the highest satisfaction (Prop: 0.93; CI 0.85-0.97). Oncoplastic breast-conserving surgery emerges as a successful approach for treating early-stage breast cancer, characterized by low associated risks and high satisfaction rates.