Correspondence to: Raafat Gendy (email: raafat.gendy1@nhs.net)
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BJS, https://doi.org/10.1093/bjs/znae306, published 24 December 2024
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Dear Editor
Mastectomy is no longer mandatory in women with a large tumour:breast ratio. This concept has been realized since the early development of oncoplastic surgery as a subspecialty in the 1990s. A large volume of the breast can be resected as long as the cosmetic penalty can be corrected with an oncoplastic procedure. Early supporting evidence from our long-term retrospective study in 2003 showed the advantage of keeping part of the natural breast in achieving fewer adverse surgical and physical sequelae than mastectomy, without compromising on oncological safety1. The original article by Davies and colleagues2 is a most welcome addition to the large volume of evidence that emerged in this regard as it provides the long-awaited evidence from a prospective multicentre trial. We look forward to seeing the long-term outcomes.
References
1. Gendy RK, Able JA, Rainsbury RM. The impact of skin-sparing mastectomy with immediate reconstruction and breast-sparing reconstruction with miniflaps on the outcomes of oncoplastic breast surgery. BJS 2003; 90: 433-439
2. Davies C, Johnson L, Conefrey C, Mills N, Fairbrother P, Holcombe C et al. Clinical and patient-reported outcomes in women offered oncoplastic breast-conserving surgery as an alternative to mastectomy: ANTHEM multicentre prospective cohort study. BJS 2025; 112, doi: https://doi.org/10.1093/bjs/znae306.
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