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ISRN Oncology
Volume 2013 (2013), Article ID 742462, 6 pages
http://dx.doi.org/10.1155/2013/742462
Review Article

From Radical Mastectomy to Breast-Conserving Therapy and Oncoplastic Breast Surgery: A Narrative Review Comparing Oncological Result, Cosmetic Outcome, Quality of Life, and Health Economy

1Department of General Surgery, Tehran University of Medical Sciences (TUMS), P.O. Box 13145-158, Tehran, Iran
2Kaviani Breast Disease Institute (KBDI), P.O. Box 14358-6443, Tehran, Iran
3School of Medicine/Public Health, Tehran University of Medical Sciences (TUMS), P.O. Box 1416135, Tehran, Iran
4Student’s Scientific Research Centre (SSRC), Tehran University of Medical Sciences (TUMS), P.O. Box 14155-6537, Tehran, Iran
5Sina Trauma and Surgery Research Centre, Tehran University of Medical Sciences (TUMS), P.O. Box 11365-3876, Tehran, Iran
6The Young Scholars Club, No. 8 West Niloofar Street, Africa (Jordan) Avenue, Tehran, Iran
7Iran’s National Elite Foundation, No. 17 Haghighat Talab Street, Southern Nejatollahi Avenue, Tehran, Iran
8Department of Surgery, Institute Curie, P.O. Box 75005, Paris, France

Received 10 July 2013; Accepted 30 July 2013

Academic Editors: P. Clavère, O. Hansen, R. V. Sionov, and K. van Golen

Copyright © 2013 Ahmad Kaviani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Surgical management of breast cancer has evolved considerably over the last two decades. There has been a major shift toward less-invasive local treatments, from radical mastectomy to breast-conserving therapy (BCT) and oncoplastic breast surgery (OBS). In order to investigate the efficacy of each of the three abovementioned methods, a literature review was conducted for measurable outcomes including local recurrence, survival, cosmetic outcome, quality of life (QOL), and health economy. From the point of view of oncological result, there is no difference between mastectomy and BCT in local recurrence rate and survival. Long-term results for OBS are not available. The items assessed in the QOL sound a better score for OBS in comparison with mastectomy or BCT. OBS is also associated with a better cosmetic outcome. Although having low income seems to be associated with lower BCT and OBS utilization, prognosis of breast cancer is worse in these women as well. Thus, health economy is the matter that should be studied seriously. OBS is an innovative, progressive, and complicated subspeciality that lacks published randomized clinical trials comparing surgical techniques and objective measures of outcome, especially from oncologic and health economy points of view.