Therapeutic Mammoplasty in Breast Cancer Surgery: Expanding the Boundaries of Breast Conservation Through Oncoplastic Integration.

Breast-conserving surgery is a standard treatment for early-stage breast cancer, providing oncologic outcomes comparable to mastectomy. However, its use is limited in patients with larger tumors or unfavorable tumor-to-breast ratios, where adequate resection may compromise aesthetic results. Therapeutic mammoplasty has emerged as an oncoplastic approach that combines tumor excision with reduction-based reconstruction, allowing wider resections while preserving breast shape. This study was conducted as a structured narrative review to provide a clinically relevant synthesis of the available evidence on therapeutic mammoplasty. Given the heterogeneity of the literature, a qualitative approach was adopted, focusing on oncologic safety, surgical feasibility, indications, and aesthetic and patient-reported outcomes. The available evidence indicates that therapeutic mammoplasty achieves oncologic outcomes comparable to standard breast-conserving surgery, with low rates of positive margins and acceptable local recurrence. The ability to perform wider resections expands the indications for breast conservation, particularly in patients who might otherwise require mastectomy. Improved aesthetic outcomes and high levels of patient satisfaction are consistently reported, and, in selected patients, additional functional benefits may be observed. Therapeutic mammoplasty represents an effective oncoplastic strategy that extends the applicability of breast-conserving surgery while maintaining oncologic safety and improving patient-centered outcomes. Its role is expected to expand as integrated oncologic and reconstructive approaches become increasingly adopted in modern breast cancer care.