The interface between breast conserving surgery with oncoplastic techniques and mastectomy: when to perform one or the other-a narrative review

Objective: The aim of this review is to describe different oncoplastic surgery techniques and indications versus mastectomy. Background: Oncoplastic breast surgery has emerged in last 2 decades as an alternative to mastectomy. It refers to the resection of the breast tumour with clear margins followed by the reconstruction of the defect using surgical plastic techniques. Oncoplastic breast surgery allows women to keep their breast with tumours that otherwise would imply a mastectomy performed. The concept of oncoplastic breast surgery requires in one side a complete oncological surgical technique and in the other performing that surgery using plastic surgery techniques. If a breast symmetry is needed or demanded by the patient it should be performed in the same operation. Oncoplastic breast surgery is a safe oncological option, and it maintains the shape of the breast without the secondary effects of foreign bodies, re -do surgery and its complications. In oncoplastic breast surgery there are two different groups of techniques available to correct the defect created after the surgical excision of the tumour: volume displacement and volume replacement. In the volume displacement technique following the resection, the defect is filled with the rest of the available breast. In volume replacement technique, autologous flaps and tissue are dissected and transposed from a close or distant place. It requires special training program that must be facilitated to all breast surgeons. Mastectomy remains the main option for patients who wish their breast to be removed or for those when breast conserving surgery is not suitable. Methods: We have searched the most relevant publications in PubMed from 1981 up to date using the keywords. Conclusions: Oncoplastic breast surgery techniques have become the best new surgical options to treat breast cancer.