Single-incision approach to aesthetic flat closure after bilateral mastectomy in morbidly obese patients.

There has been a recent emphasis to offer women who forego reconstruction after mastectomy a surgically optimized flat closure (aesthetic flat closure (AFC)). While this certainly requires attention to details not previously considered by many surgeons, additional complexity is encountered in performing this procedure in the morbidly obese patient. Most of this additional complexity revolves around resecting additional subcutaneous tissue adjacent to the breast footprint. Here, we combine two previously described techniques, one to facilitate AFC in patients with normal body mass indices (BMIs) and another approach used to facilitate removal of excess lateral subcutaneous tissue after mastectomy in patients with elevated BMIs with our single-incision approach. The single-incision approach facilitates an expedited surgical procedure and resection of excess midline tissue with more reliably symmetrical incisions bilaterally . This report describes 10 consecutive morbidly obese patients who underwent mastectomy and AFC.

Pushing the Limits of Breast-Conserving Surgery with Extreme Oncoplasty.

Introduction: We aimed to report the long-term surgical outcomes of extreme oncoplasty techniques in selected patients with unifocal (UF)/cT3 or multifocal-multicentric tumors (MFMC). Material and Methods: Patients who were initially recommended to have mastectomy underwent extreme oncoplastic breast-conserving surgery (eOBCS) including therapeutic reduction mammoplasty, racquet, and round-block mammoplasty, Grisotti flap, or combined technique were included. Preoperative tumor parameters, clinical outcomes, rate of local recurrence, survival, and patients' satisfaction were assessed. Results: Eighty-six patients with a median age of 51 years were followed for a median follow-up of 75 (8-154) months; 31 (36%) had cT3 and 55 (64%) had MFMC tumors. The majority of patients (83.6%) had invasive cancer. The median UF tumor size was 58 mm (range 51-100) on imaging and 51 mm (range 50-60) on final pathology. The median tumor span for MFMC was 65 mm (range 53-95) on imaging, whereas the median of the largest tumor size was 30 mm (range 22-60) on final pathology. Seventy-one patients (82.5%) were ER-positive, 17 (19.7%) were HER2 positive, and 8 (9.3%) were triple-negative breast cancer. Four patients (4.7%) required further intervention for having positive margins (3 re-excisions, 1 completion mastectomy). Three local recurrences (3.4%) and 10 (11.6%) distant metastasis occurred. The cosmetic outcome was excellent in 37 (43%) patients. No major complications were observed. Conclusions: eOBCS can be a good option for patients who initially require mastectomy. Appropriate patient selection, a multidisciplinary approach, and patient consent are essential steps of the procedure.

Oncoplastic breast conserving surgery versus standard breast conserving surgery for early and locally advanced breast cancer: a retrospective analysis from Sri Lanka.

BACKGROUND: Breast aesthetics is becoming increasingly important in breast cancer surgery due to changes in patient expectations and greater emphasis been placed on the psychosocial outcomes. Studies have shown no difference in local recurrence risk between mastectomy and breast conserving surgery (BCS) and also a higher overall survival rate after BCS. Breast preservation improves the quality of life substantially compared to mastectomy. Oncoplastic breast-conserving surgery (O-BCS) involves tumour excision whilst overcoming the limitations of standard breast conserving surgery (S-BCS) by allowing larger resection volumes, avoiding deformities with better aesthetic results. Our study aims to compare the oncosurgical and aesthetic outcomes of O-BCS versus S-BCS among women in Sri Lanka. METHODS: We conducted a retrospective study over a 4-year period including patients who underwent breast conservation surgery for primary non-metastatic breast cancer in two tertiary care units. We assessed outcomes in terms of re-excision rates, resection margin, complications and aesthetic outcomes using a Likert scale questionnaire to grade specific outcomes such as symmetry, volume, nipple position, scar visibility. Non-parametric tests were used for statistical analyses. RESULTS: Fifty-four and seventy-three patients underwent S-BCS and O-BCS respectively. The median specimen volume and the maximum tumour diameter were significantly higher in O-BCS [160(range:65-220); 4.2(range: 1.2-5.2)] compared to S-BCS [65(range:45-86); 2.4(range: 1.0-2.6)]. The median closest tumour margin was 16 mm (range:4-25 mm) in O-BCS while 6 mm (range:<1 - 12 mm) in S-BCS (p = 0.01). Close (< 1 mm) and positive margins needing re-excision were seen mostly in S-BCS. Superior aesthetic outcomes with statistical significant difference were reported in the O-BCS compared to S-BCS group with better symmetry, volume, nipple position and scar visibility. The re-excision rates were significantly lower in O-BCS group. There was no significant difference in the operative time and complications while the aesthetic outcomes were significantly superior in OBCS. CONCLUSIONS: Overall, Level 2 perforator flap based reconstruction had superior aesthetic outcomes. O-BCS is safe and more aesthetically acceptable with no difference in oncological outcome and operative time. More consideration should be given to aesthetic parameters such as scar visibility, nipple position, breast volume and shape when considering the best surgical option for the patients.

Manejo de un tumor benigno del pezón infrecuente en un hospital terciario. El adenoma de pezón / Management of a rare nipple benign tumor in a tertiary hospital. the nipple adenoma

El adenoma de pezón es un tumor benigno que se origina en los conductos galactóforos del pezón. El objetivo de nuestro estudio es describir y comparar con la literatura la casuística del adenoma de pezón en nuestro centro, desde enero de 2009 hasta diciembre de 2019. Nuestra serie de casos la forman 5 pacientes. Todos son mujeres, de edades comprendidas entre los 40 y los 82 años. Dos pacientes consultaron por telorragia y las restantes fueron derivadas de atención primaria por lesiones en el pezón de nueva aparición. Las pruebas de imagen no presentaron hallazgos específicos. El resultado de la biopsia preoperatoria fue diagnóstico de adenoma de pezón en todos los casos. En todos los casos se realizó exéresis simple de la lesión. Ningún paciente presentó recidiva ni aparición de carcinoma con una media de seguimiento de 31 meses. Una paciente falleció por otros motivos. Como conclusión se destaca la importancia de la biopsia y el estudio inmunfenotípico para realizar el diagnóstico diferencial con otras afecciones como la enfermedad de Paget o el carcinoma de pezón. El manejo quirúrgico no muestra cambios respecto a la literatura, prefiriendo opciones más conservadoras como la escisión local con resultados excelentes a largo plazo. (AU)

Nipple adenoma is a benign tumor that originates in the milk ducts of the nipple. The objective of our study is to describe and compare the casuistry of nipple adenoma in our center between January 2009 and December 2019 with the literature. Our case series consists of 5 patients. They are all women, aged between 40 and 82 years. Two patients consulted for telorrhagia and the rest were referred from primary care for new-onset nipple lesions. Imaging tests did not present specific findings. The result of the preoperative biopsy was diagnostic of nipple adenoma in all cases. In all cases, simple exeresis of the lesion was performed. No patient presented recurrence or appearance of carcinoma with a mean follow-up of 31 months. One patient died for other reasons. In conclusion, the importance of the biopsy and the immunophenotypic study to perform the differential diagnóstico with other pathologies such as Paget's disease or nipple carcinoma should be highlighted. Surgical management shows no changes compared to the literature, preferring more conservative options such as local excision with excellent long-term results. (AU)

Plastic surgery market share of breast reconstructive procedures: An analysis of two nationwide databases.

BACKGROUND AND OBJECTIVES: Given advances that streamline breast reconstruction (e.g., prepectoral placement, acellular dermal matrix [ADM], oncoplastic surgery), there is concern that nonplastic surgeons are performing a growing proportion of breast reconstructive procedures. The purpose of this study was to evaluate US trends in the market share of breast reconstruction performed by plastic compared to general surgeons. METHODS: IBM® MarketScan® Commercial Claims 2006-2017 and NSQIP 2005-2020 were queried to identify women who underwent mastectomy with alloplastic (tissue expander or implant-based) or free flap reconstruction, or lumpectomy with oncoplastic reconstruction (breast reduction, mastopexy, or local/regional flap). MarketScan included immediate and delayed reconstructions, while all NSQIP reconstructions were immediate. Poisson regression with incident rate ratios (IRRs) modeled trends in surgeon type over time. RESULTS: The cohort included 65 168 encounters from MarketScan and 73 351 from NSQIP. Plastic surgeons performed 95.8% of free flap, 93.8% of alloplastic, and 64.9% of oncoplastic reconstructions. Plastic surgeons performed an increasing proportion of immediate oncoplastic reduction and mastopexy (MarketScan IRR: 1.077, 95% confidence interval [CI]: 1.060-1.094, p < 0.001; NSQIP IRR: 1.041, 95% CI: 1.030-1.052, p < 0.001). There were no clinically significant trends for delayed oncoplastic, alloplastic, or free flap reconstructions. Plastic surgeons were more likely to use ADM compared to general surgeons in NSQIP (p < 0.001). CONCLUSIONS: Plastic surgeons gained market share in immediate oncoplastic breast reduction and mastopexy over the past two decades without any loss in alloplastic or free flap breast reconstruction. Plastic surgeons should continue collaboration with breast surgical oncologists to reinforce the shared surgeon model for management of breast cancer.

Therapeutic mammoplasty: a "wise" oncoplastic choice-lessons from the largest single-center cohort from Asia.

Introduction: The majority of breast cancer patients from India usually present with advanced disease, limiting the scope of breast conservation surgery. Therapeutic mammoplasty (TM), an oncoplastic technique that permits larger excisions, is quite promising in such a scenario and well suited to breast cancer in medium-to-large-sized breasts with ptosis and in some cases of large or multifocal/multicentric tumors. Here, we describe our TM cohort of 205 (194 malignant and 11 benign) patients from 2012 to 2019 treated at a single surgeon center in India, the largest Asian dataset for TM. Methods: All patients underwent treatment after careful discussions by a multidisciplinary tumor board and patient counseling. We report the clinicopathological profiles and surgical, oncological, cosmetic, and patient-related outcomes with different TM procedures. Results: The median age of breast cancer patients was 49 years; that of benign disease patients was 41 years. The breast cancer cohort underwent simple (n = 84), complex (n = 71), or extreme (n = 44) TM surgeries. All resection margins were analyzed through intra-operative frozen-section assessment with stringent rad-path analysis protocols. The margin positivity rate was found to be 1.4%. A majority of the cohort was observed to have pT1-pT2 tumors, and the median resection volume was 180 cc. Low post-operative complication rates and good-to-excellent cosmetic scores were observed. The median follow-up was 39 months. We observed 2.07% local and 5.7% distal recurrences, and disease-specific mortality was 3.1%. At median follow-up, the overall survival was observed to be 95.9%, and disease-free survival was found to be 92.2%. The patient-reported outcome measures (PROMs) showed good-to-excellent scores for all types of TMs across BREAST-Q domains. Conclusion: We conclude that in India, a country where women present with large and locally advanced tumors, TM safely expands the indications for breast conservation surgery. Our results show oncological and cosmetic outcomes at acceptable levels. Most importantly, PROM scores suggest improved overall wellbeing and better satisfaction with the quality of life. For patients with macromastia, this technique not only focuses on cancer but also improves self-image and reduces associated physical discomfort often overlooked by women in the Indian setting. The popularization of this procedure will enable Indian patients with breast cancer to receive the benefits of breast conservation.

New Technology for the Breast Surgeon.

New innovations aid the breast surgeon with better ability to localize tumors using wireless techniques, reduce re-excision rates by intraoperative margin evaluation and perform aesthetically; pleasing, and safe surgeries. In addition to improving oncological outcomes, we can continue to improve the quality of life for our patients through evolving surgeries including nerve-sparing mastectomies, robotic mastectomies, and lymphovascular surgeries (LYMPHA). Our article reviews current and evolving techniques and technology that all breast surgeons should add to his or her armamentarium to provide optimal surgical care.

Extreme oncoplasty: past, present and future.

Breast surgery has evolved from mastectomy to breast-conserving surgery (BCS). Breast oncoplastic surgery later emerged with the inclusion and development of techniques used in plastic surgery for breast neoplasms. Recently, a new paradigm has been considered for mastectomy candidates with large multifocal and multicentric tumours, designated extreme oncoplasty (EO), which has allowed new techniques to be applied to tumours that would have been ineligible for BCS before. There are few publications and no uniform descriptions grouping all the technical possibilities and new indications together. We performed this a review with the objective of evaluating the indications and surgeries performed in the EO context, representing a new perspective for BCS. We observed new indications as extensive microcalcifications, locally advanced breast carcinoma with partial response to chemotherapy, small to moderate-sized non-ptotic central tumours and extreme ptosis. Small breasts are able for EO since the presence of ptosis. New surgeries are reported as disguised geometric compensation, perforators flaps, local/regional flaps, latissimus dorsi miniflap and partial breast amputation. It is important to decrease barriers to oncoplastic surgery if we want to increase the use of EO and BCS rates.

Dermatofibrosarcoma protuberans surgery: Experiences of four African surgical oncology units and literature review.

BACKGROUND AND OBJECTIVES: Dermatofibrosarcoma is a locally malignant tumor. This gives surgery a place of choice. The advent of imatinib has improved outcomes. Our aim is to describe the indications, techniques and results of surgery. METHODS: A retrospective, multicenter, descriptive study conducted in four West African surgical oncology units. It covers dermatofibrosarcoma surgery performed between January 1, 1988 and December 31, 2020. We took into account the surgical procedure, the mode of skin coverage, adjuvant treatments and survival. Comparisons were possible using Student's t-test and Pearson's χ2 . RESULTS: We recorded 81 cases of dermatofibrosarcoma. Surgery was effective in 90.1% of cases. Wide resection was the principle with a mean resection margin of 3.8 ± 1.9 cm. healing by primary intention, flaps and healing by secondary intention were the methods of skin coverage in 30.1%, 24.7% and 41.1% respectively. The type of skin coverage was related to the topography and size of the tumor (p < 0.0001). The healing time is associated with the type of skin cover. The recurrence rate was not related to the type of skin coverage (p = 0.8). CONCLUSIONS: Wide and deep resection in the absence of Mohs micrographic surgery ensures healthy margins. Oncoplasty reduces the healing time without increasing the risk of recurrence.

Comparing oncoplastic breast reduction with immediate symmetry surgery to standard breast reduction surgery: Are postoperative complications worse?

INTRODUCTION: Oncoplastic breast reduction mammoplasty (ORM) is an excellent treatment option for women with breast cancer and macromastia undergoing breast conservation therapy. Here, we aim to better understand the risks associated with ORM compared to standard reduction mammoplasty (SRM). METHODS: A retrospective chart review was performed of patients undergoing ORM or SRM from 2015 to 2021. Primary outcomes included the occurrence of major or minor postoperative complications in the two groups and delays to adjuvant therapy (>90 days) among the women undergoing ORM. RESULTS: Women in the ORM group (n = 198) were significantly older (p < 0.001) with a higher prevalence of smoking (p < 0.001), diabetes mellitus (p < 0.01), and a Charlson comorbidity index ≥ 3 (p < 0.001) compared to women undergoing SRM (n = 177). After controlling for potential confounders, there were no significant between-group differences in the odds of developing postoperative complications (odds ratio = 0.80, 95% confidence interval: 0.36-1.69). Only 3% (n = 4) of the 150 women undergoing adjuvant radiation or chemotherapy experienced delays related to postoperative complications. CONCLUSION: ORM has a similar safety profile as SRM, despite the older age and higher number of comorbidities often seen in patients undergoing ORM, and is a safe option for achieving contralateral symmetry at the time of partial mastectomy without delays to adjuvant therapy.

Oncoplastic Surgery and the Clinical Features of Breast Cancer-Relevant Factors Associated with Reoperation in Breast Oncoplastic Surgery.

Oncoplastic breast surgery slowly becomes a part of routine breast cancer surgical management but evidence with regard to oncological safety remains limited. The aim of this study was to compare relevant factors associated with the particular type of breast carcinoma and the applied surgical techniques either with or without oncoplastic surgery. This retrospective study enrolled the breast cancer female patients who underwent breast-conserving therapy alone or with the oncoplastic surgery in the Department of Surgical Oncology at the Center of Oncology of the Lublin Region St. Jana from Dukli in the years 2008-2011. The study involves 679 breast cancer patients who underwent oncoplasty (n = 81) and the control group (n = 598). There is a significant relationship between the histological type of breast cancer (p = 0.00000) along with the expression of estrogen and/or progesterone receptors (p = 0.01285) and the usage of oncoplastic surgery in breast cancer patients. Interestingly, in the majority of cases, there was no need to conduct a reoperation. Oncoplastic surgery is an effective and safe strategy that might be favorable especially for those patients who are potential candidates for more invasive surgical methods. High-quality evidence to support the oncological safety and benefits of oncoplastic breast surgery is lacking.

Limberg Flap in Breast Oncoplasty for Carcinoma Breast Revisited-a Tertiary Cancer Centre Experience.

Limberg flap is currently not commonly used in breast oncoplasty. We present our experience with Limberg flap reconstruction in breast cancer patients who underwent breast conservation surgery. This study was conducted at a tertiary cancer centre in Kerala, India. We reviewed the records of patients with breast cancer who underwent Limberg flap reconstruction with breast conservation surgery from 1st January 2020 to 31st October 2021. Data collected included age, quadrant of tumour, side of tumour, T and N stage, status at surgery (primary or post neoadjuvant therapy), type of surgery, flap complications following surgery and breast deformity following surgery. Seventeen patients underwent Limberg flap reconstruction during the study period. The median age of the patients was 51 years. The commonest stage was cT1N0M0. Twelve patients underwent primary surgery and 5 post neoadjuvant chemotherapy. No patient had postoperative flap complications or breast deformity. Limberg flap is simple, versatile and robust and should be a part of the armamentarium of breast surgeons.

Reduction Mammoplasty Approach to Oncoplasty-Zone-Wise Planning in Indian Patients.

Introduction This article is an attempt to formulate certain guidelines for planning of zone-wise reconstruction after breast conservation surgery. The planning involves applying reduction mammoplasty principles with certain modifications to address the defect. Patients and Methods This is a retrospective study of 61 patients with breast cancer who underwent breast conservation surgery and reconstruction of partial breast defects with oncoplastic techniques between January 2014 to March 2019. Patients having low tumor to breast ratio and thus good candidates for volume displacement techniques were included in the study. Results A total of 61 breast cancer cases were included; 22 cases were located in zone 1, nine in zone 2, seven in zone 3, three in zone 4, four in zone 5, one in zone 6, 12 in zone 7, two in zone 8, and three in zone 9. The most common pedicle design used was superomedial in 38 cases, followed by inferior in 19 and medial in 6 cases. Vertical short scar technique was used in 33 cases and Wise pattern skin incision in 30 cases. Follow-up period ranged from 4 months to 65 months, with a mean of 31 months. Four patients had partial skin necrosis, three had suture line dehiscence, two had wound infection, one had seroma, and eight patients had fat necrosis. All patients were satisfied with the cosmetic outcome. Conclusion Breast oncoplastic techniques are effective, reliable, oncologically safe, and conducted with minimal complications in patients with moderately large ptotic breasts, thereby making planning easier and more reproducible by following the reconstruction procedures described in the article. We believe that these techniques should be incorporated in the armamentarium of every plastic surgeon to manage the defects created after breast conservation surgery, in order to achieve the best cosmetic outcomes.

Oncoplastic breast surgery to treat recurrent granulomatous abscess: A new approach.

INTRODUCTION AND IMPORTANCE: Granulomatous mastitis is a rare chronic and benign inflammatory breast disease with challenging diagnosis and management. No commonly recognized recommendations are established. Despite of medical and surgical approaches, relapse rate remains high. CASE PRESENTATION: A 43-year-old patient with a history of granulomatous mastitis presented recurrent breast abscess associated with skin fistula. She underwent Racquet mammoplasty procedure inspired from oncoplastic techniques. Medical and cosmetic outcomes were satisfactory. CLINICAL DISCUSSION: Granulomatous mastitis is challenging to diagnose and can be confused with inflammatory breast malignancies. It's associated with high relapse rate. Management of granulomatous mastitis is complex. Its treatment varies from medical management based on steroid therapy and immunosuppressants to surgical approach. In case of recurrent breast abscess, surgical techniques inspired from oncoplastic breast surgery, can be used to improve cosmetic outcome. CONCLUSION: Oncoplastic surgical technic may be considered as an efficient procedure to manage recurrent breast granulomatous abscess.

Use of Lateral Oncoplasty for Multiquadrant Giant Fibroadenoma: A Novel Approach.

Giant fibroadenomas are uncommon benign lesions, defined as fibroadenomas of >5 cm in size and/or weighing more than 500 g. They can distort the shape of the breast and cause asymmetry, so they should be excised. Here, we report two cases of giant fibroadenoma, where wide local excision and reconstruction with lateral oncoplasty were done. Compared to all previous reports of patients with giant fibroadenoma, where the lump was excised either through a submammary incision or by round block technique depending on the location of the tumour, we used the lateral oncoplasty technique in both patients. Lateral oncoplasty is a new reconstructive option to maintain cosmesis and symmetry after the excision of giant fibroadenomas in the outer and central quadrants of the breast. It is a good option for reconstruction in cases where the defect is very large and facilities for conventional flap surgeries are not available.

Extreme Oncoplasty: Breast Conservation in Patients with Large, Multifocal, and Multicentric Breast Cancer.

INTRODUCTION: Extreme Oncoplastic Breast Conservation Surgery (EOBCS) is offered in selected patients with multifocal or multicentric breast cancer (MFMC). Recent evidence has suggested that EOBCS may be a valuable resource for patients with MFMC who may avoid the risk associated with mastectomy in favour of the benefits of breast conservation without risking their oncological outcomes. Our study examined the practice of EOBCS in two regional breast units in Glasgow, United Kingdom. MATERIALS AND METHODS: A prospectively collected database of 50 patients treated with EOBC in two breast units in Glasgow between 2007 and 2018 were evaluated, and clinical outcomes were observed. RESULTS: Fifty patients (median age 55) underwent EOBCS, of which 43 (86%) had invasive disease. Median tumour size was 55mm (50-90) and multifocal disease was identified in 22 (44%) patients. Nine patients (18%) were found to have positive margins and underwent a second procedure, with 6 (12%) proceeding to mastectomy. Five-year disease free survival rate was 91.5%, while cancer-specific survival was 95.7%. CONCLUSION: EOBCS is oncologically safe in short-term follow-up. Large scale studies are required to confirm these preliminary results, in order to offer EOBCS as a valid option to patients with advanced or multifocal breast cancer.

Breast conservation surgery & oncoplasty in India - Current scenario.

Breast cancer incidence is on the rise in India as in rest of the world. While the advances in overall cancer care are at par, the surgical interventions have not been changing at the same pace in India, as in the rest of the developed world. Partly, this is due to the relatively more advanced state of cancer at detection and partly due to lack of awareness resulting in apprehension and slow acceptance of de-escalation of surgical interventions by the treating surgeons, and the beneficiaries, the patients. The article looks at the current scenario, available evidence on the practices and pitfalls with possible solutions for advancing surgical care of breast cancer in India.

Extreme oncoplasty for centrally located breast cancer in small non-ptotic breasts: extending the indications of chest wall perforator flaps with areolar reconstruction.

BACKGROUND: Breast cancers located centrally require excision of nipple-areola complex. A simple central wide excision is a safe option but results in suboptimal aesthetic outcome. An oncoplastic option involves therapeutic mammoplasty with or without areolar reconstruction, limited to moderate and large ptotic breasts. For small non-ptotic breasts, most surgeons would resort to mastectomy with/without reconstruction. METHODS: Lateral chest wall perforator flap (CWPF) is an option for partial breast reconstruction in small to moderate sized, non-ptotic breasts for laterally located tumours. We have extended the application of CWPF for central tumours to avoid mastectomy in selected patients. RESULTS: We here present a case series of four patients with small to medium-sized non-ptotic breasts, who had centrally located breast cancer or ductal carcinoma in-situ (DCIS). Three patients had single stage CWPF reconstruction, and one had central excision with immediate reconstruction following a failed attempt at therapeutic mammoplasty. All had the areola reconstructed using flap skin; one patient had simultaneous nipple reconstruction. CONCLUSIONS: CWPF is an option for treatment of centrally located breast cancers/DCIS needing nipple-areola complex excision for patients wishing to avoid mastectomy. Patients with small to medium-sized non-ptotic breasts are suitable, and need to be carefully selected.

Impact of contemporary therapy- concepts on surgical morbidity in breast cancer patients: A retrospective single center analysis of 829 patients.

INTRODUCTION: Morbidity after breast cancer surgery remains low with revision surgery below 5%. This retrospective monocentric study investigates whether new methods like neoadjuvant chemotherapy (nCT), oncoplastic surgery (OPS) or intraoperative radiotherapy (IORT) affect overall morbidity. In addition, we sought to determine a possible effect of morbidity on oncologic outcome. METHODS: Clinical Data from all breast cancer cases, operated at the OnkoZert"- certified Breast Health Center of the "Sisters of Charity Hospital" in Linz between 2011 and 2014, were evaluated. Age (≤/>70), nCT, IORT, surgical technique and histological subtypes were analyzed concerning their impact on morbidity. Overall survival (OS) and disease-free survival (DFS) were assessed by Kaplan-Meier estimates. RESULTS: 829 patients were included, 24% were older than 70y, 19% underwent oncoplasty, 5.5% immediate reconstruction, 17% of the invasive cancers were treated with nCT and 4.1% received IORT. One or more complications occurred in 83 patients (10%), while 62 patients (7.5%) underwent revision surgery. Univariate analysis showed that mastectomy and age >70 doubled the risk of surgical morbidity. Multivariate regression analysis identified age >70 as the only independent prognostic parameter for the occurrence of morbidity (OR: 2.42, 95% CI: 1.41-4.1, p = 0,00134). Morbidity was not associated with worse oncologic outcome in terms of OS or DFS. SUMMARY: In our patient collective, modern techniques such as nCT, OPS or IORT did not influence surgical morbidity rates. Those were only increased by patient's age. Additionally, surgical morbidity did not show any significant impact on OS and DFS.