Does oncoplastic breast-conserving surgery provide superior esthetic and functional outcomes compared with conventional breast-conserving surgery? A retrospective matched-pair study from a high-volume tertiary center in Türkiye.

Abstract

Oncoplastic breast-conserving surgery (OPC) aims to combine oncological safety with improved esthetic and functional outcomes. However, comparative data incorporating patient-reported outcome measures (PROMs), particularly sexual function, remain limited. We evaluated patient-reported and clinical outcomes of OPC compared with conventional breast-conserving surgery (BCS) in a contemporary Turkish cohort. This single-center retrospective matched-pair cohort study included women with early-stage (T1-T2, N0-N1, and M0) invasive breast cancer or ductal carcinoma in situ who underwent segmental mastectomy between January 2019 and April 2025. From approximately 1000 screened cases, 132 OPC patients were 1:1 matched to 132 BCS patients by age, tumor size, T stage, nodal status, histology, laterality, and year of diagnosis. Primary outcomes were patient satisfaction and quality of life assessed using the BREAST-Q (Reduction/Mastopexy module) and sexual function assessed with the Arizona Sexual Experiences Scale (ASEX). Secondary outcomes included margin status, complications, and perioperative variables. The final cohort comprised 264 patients with comparable baseline characteristics. OPC was associated with longer operative time but showed similar margin positivity (0-0.8%) and overall complication rates compared with BCS. Median BREAST-Q scores were significantly higher following OPC (80 vs. 71; p < 0.001), indicating superior esthetic and psychosocial outcomes. Median ASEX scores were lower in the OPC group (14 vs. 17; p < 0.001), reflecting better sexual function. OPC provides significantly improved patient-reported satisfaction and sexual function without compromising oncological safety or perioperative outcomes. These findings support OPC as a patient-centered evolution of BCS and emphasize the importance of integrating PROMs into routine breast cancer care.