Evidence map›Paper›PMID 39798277›Full record

SynthesisBreast (Edinburgh, Scotland)2025

Oncological outcomes following extreme oncoplastic breast conserving surgery (eOPBCS) for locally advanced breast cancer (LABC): A systematic review and meta-analysis.

Megan Chua Wern Ee, Ashley Lee Shi Hui, Wong Hung Chew, Emmeline Elaine Cua-Delos Santos, Sean Li Siwei, Sng Ming Xian, Qin Xiang Ng, Serene Goh Si Ning

Abstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Breast (Edinburgh, Scotland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Megan Chua Wern EeYong Yoo Lin School of Medicine, National University of Singapore, Singapore.
Ashley Lee Shi HuiYong Yoo Lin School of Medicine, National University of Singapore, Singapore.
Wong Hung ChewResearch Support Unit, NUS Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Emmeline Elaine Cua-Delos SantosDepartment of General Surgery, Breast Division, National University Health System, Singapore.
Sean Li SiweiLee Kong Chian School of Medicine, Nanyang Technological University (NTU), Singapore.
Sng Ming XianLee Kong Chian School of Medicine, Nanyang Technological University (NTU), Singapore.
Qin Xiang NgSaw Swee Hock School of Public Health, National University of Singapore, Singapore.
Serene Goh Si NingYong Yoo Lin School of Medicine, National University of Singapore, Singapore; Department of General Surgery, Breast Division, National University Health System, Singapore; Saw Swee Hock School of Public Health, National University of Singapore, Singapore; National University Cancer Institute of Singapore, Singapore. Electronic address: serene_sn_goh@nuhs.edu.sg.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionLocally advanced breast cancer (LABC) accounts for 5 % of new breast cancer diagnoses in developed countries and 30-60 % in developing regions. Historically, treatment relied on mastectomy guided by the Halstedian theory. Advances in neoadjuvant chemotherapy (NACT), breast-conserving surgery (BCS), and radiation have transformed treatment into a multimodal approach. Extreme oncoplastic BCS (eOPBCS) has expanded the boundaries of BCS, enabling large-volume resections with breast reshaping. However, its oncologic outcomes compared to mastectomy remain unclear, particularly in LABC.

methodsA systematic review and meta-analysis were conducted following PRISMA guidelines (PROSPERO: CRD42024535182). Studies involving eOPBCS for LABC were reviewed, and those comparing outcomes with mastectomy were included in the meta-analysis. The primary outcomes were overall survival (OS), disease-free survival (DFS), and local recurrence rates (LRR). Data were synthesized using a random-effects model.

resultsOf 866 identified studies, 33 were included in the systematic review and 4 in the meta-analysis, involving 2902 patients with LABC. Among them, 16.1 % underwent eOPBCS. Patients receiving eOPBCS were younger, had larger tumours, and more frequently underwent axillary clearance. The pooled hazard ratio (HR) for OS comparing mastectomy to eOPBCS was 1.72 (95% CI 1.04-2.83). Meanwhile, HRs for DFS (1.11, 95% CI 0.60-2.08) and LRR (0.67, 95% CI 0.38-1.18) showed that there were no statistically significant differences but a trend toward lower recurrence rates with mastectomy.

conclusioneOPBCS demonstrates comparable to superior oncological outcomes to mastectomy in LABC, offering a promising option for selected patients. However, slightly elevated local recurrence rates, though not statistically significant, highlight the importance of careful patient selection and further research. High-quality prospective studies are essential to validate these findings and refine criteria for incorporating eOPBCS into routine clinical practice.

Indexed as

Breast NeoplasmsMastectomy, SegmentalDisease-Free SurvivalFemaleHumansMastectomyMiddle AgedNeoplasm Recurrence, LocalTreatment Outcome

Identifiers

PMID39798277
PMCPMC11872608

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.