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.

[BACKGROUND] 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.

[METHODS] 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.

[RESULTS] 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.

[CONCLUSIONS] 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.