Comment on (Extreme Oncoplastic Surgery for Multifocal/Multicentric and Locally Advanced Breast Cancer)

We read with interest the work of Chaitanyanand Koppiker and colleagues [1] and would like to add some useful suggestions to improve oncological and cosmetic outcomes. Extreme oncoplastic surgery (EOS) is a breast conserving operation, using oncoplastic techniques, in a patient who requires a mastectomy. It is a promising new concept in the multidisciplinary treatment of selected patients with generally large, greater than 5 cm multifocal or multicentric tumor desiring breast conservation [2–4]. Tese oncoplastic techniques allow the resection of a greater amount of breast tissue with safer margins and acceptable aesthetic results increasing breast conservation rates [5–8]. Te indications for EOS are diferent and various algorithms have been devised to assist with the decision process [3–5]. Long-term data on recurrence and survival are not available, using this approach. It is expected that the local recurrence will be somewhat higher but that there will be little or no impact on survival [3, 9]. Chaitanyanand Koppiker and colleagues conclude in their study that “Extreme Oncoplastic Surgery followed by RT results in acceptable local-regional control, low rate of complications, and high patient satisfaction. In selected patients, EO could provide a safe alternative for breast conservation surgery instead of mastectomy” [1].