Oncoplastic Versus Standard Breast-conserving Surgery: Predictors of Re-excision, Complications, and Safety Outcomes

Background: Oncoplastic breast-conserving surgery (OBCS) combines tumor resection with immediate reconstruction to improve cosmetic outcomes and increase breast conservation rates. We compared outcomes of OBCS versus standard breast-conserving surgery (SBCS). Methods: We retrospectively analyzed 237 breast cancer patients (137 OBCS, 100 SBCS) treated from 2020 to 2024. Clinicopathologic factors, complications, re-excision, and recurrence rates were evaluated. Logistic regression was used to identify predictors of re-excision. Results: Re-excision was required in 20.7% of cases, significantly more often after OBCS than SBCS (26.3% versus 13.0%, P = 0.013). Positive margin rates were significantly higher with OBCS (17.5% versus 5.0%, P = 0.004). Older age and stage II disease predicted re-excision. Recurrence rates were similar between groups. Conclusions: OBCS had higher positive margin and re-excision rates than SBCS. Improved intraoperative margin assessment and patient selection may reduce re-excision rates.