Penanganan Bedah Tumor Mammae: Studi terhadap Efektivitas Teknik Onkoplastik dan Konservasi Payudara dalam Menurunkan Morbiditas Pasca Operasi

Rudi Haris Munandar

doi:10.55681/sentri.v5i2.5681

Authors

Rudi Haris Munandar Universitas Riau

DOI:

https://doi.org/10.55681/sentri.v5i2.5681

Keywords:

Breast Cancer, Oncoplastic, Breast-Conserving Surgery, Postoperative Morbidity

Abstract

Breast cancer remains one of the most prevalent malignancies globally, prompting continuous refinement of surgical strategies to achieve optimal oncological control while preserving patients’ physical integrity and quality of life. The transition from radical mastectomy toward breast-conserving surgery and oncoplastic approaches reflects a paradigm shift that prioritizes both tumor eradication and postoperative functional–aesthetic outcomes. This study systematically evaluates the effectiveness of oncoplastic and breast-conserving techniques in reducing postoperative morbidity among patients with breast tumors. The research employed a Systematic Literature Review (SLR) guided by the PRISMA framework, focusing on peer-reviewed articles published within the past decade that addressed conservative surgical methods and reported morbidity-related outcomes. From 325 articles initially identified across multiple databases, 75 duplicates were removed, leaving 250 records for title and abstract screening. Subsequently, 125 articles underwent full-text review; 40 were excluded due to inaccessibility, and 55 did not meet the eligibility criteria. Ultimately, 30 studies fulfilled all inclusion requirements and were analyzed comprehensively. The findings indicate that oncoplastic surgery expands the eligibility criteria for breast-conserving procedures without elevating local recurrence rates, while simultaneously improving cosmetic satisfaction and overall quality of life. Conventional breast-conserving surgery combined with radiotherapy demonstrates long-term oncological safety comparable to mastectomy, with added advantages in maintaining body image and psychosocial well-being. Determinants of successful outcomes include anatomical suitability, tumor dimension and topography, surgical expertise, multidisciplinary collaboration, and institutional support systems. Collectively, the evidence underscores that integrative surgical approaches balancing oncological rigor and reconstructive precision contribute significantly to lowering postoperative morbidity.

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References

Awad, S., Tarabay, A., Qahtani, F. H., Alsulaimani, F. S., Shaat, M. M., Ali, M. A., Khalid, A. H., Alharthi, Q. M., ALThomali, M. A., Althobaiti, S. S., AlAmri, N. G., Alturkistani, A. M., Alshamrani, A. A., Ali, A. A., Alsufyani, A. H., AlSofyani, F. M., Alghuraybi, A. A., Alnefaie, A. M., Alharthi, S. A., … Abou Sheishaa, M. S. (2021). Aesthetic monitoring-based assessment of oncological safety of oncoplastic management of breast cancer: a multi-center research study. BMC Surgery, 21(1), 1–10. https://doi.org/10.1186/s12893-021-01410-0

Benedict, K. C., Brown, M. I., Berry, H. A., Berry, S. M., O’Brien, R. C., & Davis, J. M. (2023). Oncoplastic Breast Reduction: A Systematic Review of Postoperative Complications. Plastic and Reconstructive Surgery - Global Open, 11(10), E5355. https://doi.org/10.1097/GOX.0000000000005355

Casella, D., Fusario, D., Pesce, A. L., Marcasciano, M., Lo Torto, F., Luridiana, G., De Luca, A., Cuomo, R., & Ribuffo, D. (2023). Portable Negative Pressure Wound Dressing in Oncoplastic Conservative Surgery for Breast Cancer: A Valid Ally. Medicina (Lithuania), 59(10), 1–9. https://doi.org/10.3390/medicina59101703

Creswell, J. (2016). Research design Research design. Research in Social Science: Interdisciplinary Perspectives, September, 68–84. https://www.researchgate.net/publication/308915548%0Afile:///E:/Documents/dosen/buku Metodologi/[John_W._Creswell]_Research_Design_Qualitative,_Q(Bookos.org).pdf

Creswell, J. (2017). Qualitative Inqury Research Design Choosing Among Five Approaches.

Creswell, J. W., & Creswell, J. D. (2018). Mixed Methods Procedures. In Research Defign: Qualitative, Quantitative, and Mixed M ethods Approaches.

Ebeed, T. A., Gareer, W. Y., Malt, O. A. El, Marakby, H. H. El, & Fakhr, I. (2022). Optimizing Volume Displacement Oncoplastic Options in Breast Conservative Surgery for Early Breast Cancer. Jordan Journal of Applied Science - Natural Science Series, 16(2), 0–5. https://doi.org/10.35192/jjoas-n.v16i2.1838

Ghilli, M., Mariniello, M. D., Ferrè, F., Morganti, R., Perre, E., Novaro, R., Colizzi, L., Camilleri, V., Baldetti, G., Rossetti, E., Coletti, L., Scatena, C., Ghilardi, M., Cossu, M. C., & Roncella, M. (2023). Quality of life and satisfaction of patients after oncoplastic or traditional breast-conserving surgery using the BREAST-Q (BCT module): a prospective study. Breast Cancer, 30(5), 802–809. https://doi.org/10.1007/s12282-023-01474-1

Gilmour, A., Cutress, R., Gandhi, A., Harcourt, D., Little, K., Mansell, J., Murphy, J., Pennery, E., Tillett, R., Vidya, R., & Martin, L. (2021). Oncoplastic breast surgery: A guide to good practice. European Journal of Surgical Oncology, 47(9), 2272–2285. https://doi.org/10.1016/j.ejso.2021.05.006

Haddaway, N. R., Page, M. J., Pritchard, C. C., & McGuinness, L. A. (2022). PRISMA2020: An R package and Shiny app for producing PRISMA 2020-compliant flow diagrams, with interactivity for optimised digital transparency and Open Synthesis. Campbell Systematic Reviews, 18(2), e1230. https://doi.org/https://doi.org/10.1002/cl2.1230

He, S., & Yin, J. (2021). Advocating for closer collaboration in breast surgery and breast reconstruction: a narrative review. Annals of Breast Surgery, 5(3), 31–31. https://doi.org/10.21037/abs-20-64

Heeling, E., van Hemert, A. K. E., & Vrancken Peeters, M.-J. T. F. D. (2023). A clinical perspective on oncoplastic breast conserving surgery. Translational Breast Cancer Research, 4, 29–29. https://doi.org/10.21037/tbcr-23-40

Khamis, A. S., Khalil, M., Yehia, A., & Ibrahim, M. (2024). Evaluation of Oncoplastic Techniques for Conservative Breast Surgery. Benha Journal of Applied Sciences, 9(1), 141–146. https://doi.org/10.21608/bjas.2024.263086.1309

Koppiker, C. B., Kelkar, D. A., Kulkarni, M., Kadu, S., Pai, M., Dhar, U., Deshmukh, C., Varghese, B., Zamre, V., Jumle, N., Gangurde, N., Joshi, A., Unde, R., Banale, R., Namewar, N., Vaid, P., Busheri, L., Thomas, G., Nare, S., … Badve, S. (2023). Impact of oncoplasty in increasing breast conservation rates Post neo-adjuvant chemotherapy. Frontiers in Oncology, 13(September), 1–16. https://doi.org/10.3389/fonc.2023.1176609

Lauritzen, E., Bredgaard, R., Bonde, C., Jensen, L. T., Tvedskov, T., & Damsgaard, T. E. (2024). Indocyanine green angiography for autologous breast reconstruction: a prospective observational study. Annals of Breast Surgery, 8, 17–17. https://doi.org/10.21037/abs-23-53

Loibl, S., André, F., Bachelot, T., Barrios, C. H., Bergh, J., Burstein, H. J., Cardoso, M. J., Carey, L. A., Dawood, S., Del Mastro, L., Denkert, C., Fallenberg, E. M., Francis, P. A., Gamal-Eldin, H., Gelmon, K., Geyer, C. E., Gnant, M., Guarneri, V., Gupta, S., … Harbeck, N. (2024). Early breast cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up. Annals of Oncology, 35(2), 159–182. https://doi.org/10.1016/j.annonc.2023.11.016

Mason, E. J., Di Leone, A., Franco, A., D’Archi, S., Rianna, C., Sanchez, A. M., Murando, F., Accetta, C., Scardina, L., Terribile, D. A., Masetti, R., & Franceschini, G. (2022). Oncoplastic Breast Surgery versus Conservative Mastectomy in the Management of Large Ductal Carcinoma In Situ (DCIS): Surgical, Oncological, and Patient-Reported Outcomes. Cancers, 14(22). https://doi.org/10.3390/cancers14225624

Metz, G., Snook, K., Sood, S., Baron-Hay, S., Spillane, A., Lamoury, G., & Carroll, S. (2022). Breast Radiotherapy after Oncoplastic Surgery— A Multidisciplinary Approach. Cancers, 14(7), 1–21. https://doi.org/10.3390/cancers14071685

Mubarok, Sari, Wibowo, M. (2025). Comparative Study of Artificial Intelligence (AI) Utilization in Digital Marketing Strategies Between Developed and Developing Countries: A Systematic Literature Review. Ilomata International Journal of Management, 6(1), 156–173. https://doi.org/10.61194/ijjm.v6i1.1534

Oliveira-Junior, I. de, Haikel, R. L., & Vieira, R. A. da C. (2021). Breast-conserving treatment in oncoplastic times: indications, cosmesis, and quality of life. Mastology, 31, 1–9. https://doi.org/10.29289/2594539420200040

Sakina Abidi, S., Mushtaque Vohra, L., Rizwan Javed, M., & Khan, N. (2021). Oncoplastic surgery: A suitable alternative to conventional breast conserving surgery in low - Middle income countries; a retrospective cohort study. Annals of Medicine and Surgery, 68(July), 102618. https://doi.org/10.1016/j.amsu.2021.102618

Sugiyono. (2019). Metode Penelitian Kuantitatif Kualitatif (3rd ed.). Alfabeta.

Thompson, P. W., Chatterjee, A., & Losken, A. (2022). Standards in oncoplastic breast-conserving surgery. Annals of Breast Surgery, 6(1), 37–37. https://doi.org/10.21037/abs-21-33

Tramm, T., & Kaidar-Person, O. (2023). Optimising post-operative radiation therapy after oncoplastic and reconstructive procedures. Breast, 69(March), 366–374. https://doi.org/10.1016/j.breast.2023.03.013

Vindigni, V., Marena, F., Zanettin, C., & Bassetto, F. (2024). Breast Reconstruction: The Oncoplastic Approach. Journal of Clinical Medicine, 13(16). https://doi.org/10.3390/jcm13164718

Weber, W. P., Hanson, S. E., Wong, D. E., Heidinger, M., Montagna, G., Cafferty, F. H., Kirby, A. M., & Coles, C. E. (2024). Personalizing Locoregional Therapy in Patients With Breast Cancer in 2024: Tailoring Axillary Surgery, Escalating Lymphatic Surgery, and Implementing Evidence-Based Hypofractionated Radiotherapy. American Society of Clinical Oncology Educational Book, 44(3). https://doi.org/10.1200/edbk_438776

Wignarajah, P., Malata, C. M., & Benson, J. R. (2023). Oncoplastic and reconstructive breast surgery. Frontiers in Oncology, 13(June), 1–19. https://doi.org/10.3389/fonc.2023.1176915

Wijesinghe, K., Abeywickrama, T., Chamara, Y., De Silva, S., Tharshan, S., Jayarajah, U., & De Silva, A. (2023). Oncoplastic breast conserving surgery versus standard breast conserving surgery for early and locally advanced breast cancer: a retrospective analysis from Sri Lanka. BMC Surgery, 23(1), 1–9. https://doi.org/10.1186/s12893-023-02182-5

Zaher, N. A., Rashad, H., Baiuomy, M., Desouky, S. R. M., & Abourizk, M. I. (2024). Evaluation of Functional Outcome of Oncoplastic Breast Surgery for Malignant Tumor in The Upper Half of The Breast. The Egyptian Journal of Hospital Medicine, 97(3), 3906–3911.

Zhang, X., Jiang, P., & Yang, J. (2024). Effects of oncoplastic breast-conserving surgery on the psychological status, quality of life and survival prognosis of patients with early-stage breast cancer. European Journal of Gynaecological Oncology, 45(4), 43. https://doi.org/10.22514/ejgo.2024.066