Surgical complications after oncoplastic resections in patients with breast cancer

Purpose of the study. To analyze published data on the incidence and characteristics of surgical complications following oncoplastic resections in patients with breast cancer (BC).
Materials and methods. The results of 27 domestic and international publications published between 2013 and 2025 were analyzed. Relevant sources were searched in the PubMed, Cochrane Library, and eLibrary databases.
Results. According to the literature, the most common complications after oncoplastic resections in patients with breast cancer included wound dehiscence (3–9 %), seroma/hematoma (2–5 0 %), liponecrosis (1–5 %), infectious complications (4–20 %), and ischemic complications (0.8–2.5 %). The frequency and nature of surgical complications following oncoplastic and reconstructive procedures have been investigated in numerous studies. It is evident that the development of complications after reconstructive procedures may negatively affect patients’ quality of life. A thorough analysis of the causes of complications and strategies for their management allows surgeons to objectively assess the advantages and limitations of different techniques when planning the extent of surgical treatment.
Conclusion. The literature review indicates that various oncoplastic resection techniques, despite the potential occurrence of complications, are not associated with a statistically significant deterioration in aesthetic outcomes or oncological treatment results. However, careful patient selection is required to minimize the risk of surgical complications when choosing among different oncoplastic resection techniques.

1. Malignant neoplasms in Russia in 2023 (morbidity and mortality). Edited by Kaprin AD, Starinsky VV, Shakhzadova AO. Мoscow: P. Hertsen Moscow Oncology Research Institute – Branch of the National Medical Radiology Research Centre of the Ministry of Health of the Russian Federation, 2024, 276 p. (In Russ.). Available at: https://oncology-association.ru/wp-content/uploads/2024/08/zis-2023-elektronnaya-versiya.pdf (accessed: 18.02.2026).

2. Rasskazova EA, Zikiryakhodzhaev AD, Kaprin AD. Oncoplastic and organ-preserving resections of mammary gland in cancer. Medical Alphabet. 2022;5:42–45. (In Russ.).

3. Kit OI, Przhedetskiy YuV, Larina NI, Przhedetskaya VYu, Pozdnyakova VV, Shatova YuS. Oncoplastic breast reduction without formation of a pedicle of the nipple-areolar complex. Plastic Surgery and Aesthetic Medicine. 2022;4:18–27. (In Russ.). https://doi.org/10.17116/plast.hirurgia202204118

4. Shabunin AS, Grekov DN, Lebedinsky IN, Dolidze DD, Sukhotko AS. Oncoplastic resections for breast cancer. Malignant Tumoursis. 2021;11(3S1):30–31. (In Russ.).

5. Rose M, Manjer J, Ringberg A, Svensson H. Surgical strategy, methods of reconstruction, surgical margins and postoperative complications in oncoplastic breast surgery. Eur J Plast Surg. 2014;37(4):205–214. https://doi.org/10.1007/s00238-013-0922-4

6. Crown A, Scovel LG, Rocha FG, Scott EJ, Wechter DG, Grumley JW. Oncoplastic breast conserving surgery is associated with a lower rate of surgical site complications compared to standard breast conserving surgery. Am J Surg. 2019 Jan;217(1):138–141. https://doi.org/10.1016/j.amjsurg.2018.06.014

7. Losken A, Pinell-White X, Hart AM, Freitas AM, Carlson GW, Styblo TM. The oncoplastic reduction approach to breast conservation therapy: benefits for margin control. Aesthet Surg J. 2014 Nov;34(8):1185–1191. https://doi.org/10.1177/1090820x14545618

8. Haloua MH, Krekel NM, Winters HA, Rietveld DH, Meijer S, Bloemers FW, van den Tol MP. A systematic review of oncoplastic breast-conserving surgery: current weaknesses and future prospects. Ann Surg. 2013 Apr;257(4):609–620. https://doi.org/10.1097/sla.0b013e3182888782

9. Piper ML, Esserman LJ, Sbitany H, Peled AW. Outcomes Following Oncoplastic Reduction Mammoplasty: A Systematic Review. Ann Plast Surg. 2016 May;76 Suppl 3:S222–226. https://doi.org/10.1097/sap.0000000000000720

10. Hillberg NS, Meesters-Caberg MAJ, Beugels J, Winkens B, Vissers YLJ, van Mulken TJM. Delay of adjuvant radiotherapy due to postoperative complications after oncoplastic breast conserving surgery. Breast. 2018 Jun;39:110–116. https://doi.org/10.1016/j.breast.2018.04.005

11. Adamson K, Chavez-MacGregor M, Caudle A, Smith B, Baumann D, Liu J, Schaverien M. Neoadjuvant Chemotherapy does not Increase Complications in Oncoplastic Breast-Conserving Surgery. Ann Surg Oncol. 2019 Sep;26(9):2730–2737. https://doi.org/10.1245/s10434-019-07408-6

12. Russo AL, Taghian AG. Fat necrosis of the breast in the accelerated partial breast irradiation era: the need for a universal grading system. Breast Cancer Res Treat. 2013 Jul;140(1):1–11. https://doi.org/10.1007/s10549-013-2611-1

13. Nakada H, Inoue M, Furuya K, Watanabe H, Ikegame K, Nakayama Y, Ohmori M, Nakagomi H. Fat necrosis after breast-conserving oncoplastic surgery. Breast Cancer. 2019 Jan;26(1):125–130. https://doi.org/10.1007/s12282-018-0901-5

14. Teoh LY, Lai LL, Hanim Aa A, Teh MS, Jamaris S, Yahya A, et al. Oncological safety and postoperative complications in oncoplastic breast surgery among Asian women: A single institutional review. Breast J. 2020 Nov;26(11):2208–2212. https://doi.org/10.1111/tbj.14060

15. Oberhauser I, Zeindler J, Ritter M, Levy J, Montagna G, Mechera R, et al. Impact of Oncoplastic Breast Surgery on Rate of Complications, Time to Adjuvant Treatment, and Risk of Recurrence. Breast Care (Basel). 2021 Oct;16(5):452–460. https://doi.org/10.1159/000511728

16. Colwell AS, Tessler O, Lin AM, Liao E, Winograd J, Cetrulo CL, Tang R, Smith BL, Austen WG Jr. Breast reconstruction following nipple-sparing mastectomy: predictors of complications, reconstruction outcomes, and 5-year trends. Plast Reconstr Surg. 2014 Mar;133(3):496–506. https://doi.org/10.1097/01.prs.0000438056.67375.75

17. Matsen CB, Mehrara B, Eaton A, Capko D, Berg A, Stempel M, et al. Skin Flap Necrosis After Mastectomy With Reconstruction: A Prospective Study. Ann Surg Oncol. 2016 Jan;23(1):257–264. https://doi.org/10.1245/s10434-015-4709-7

18. Shatova IuS, Maksimova NA, Vashchenko IN, Shevchenko NA, Chernikov EN. Long-term outcomes of oncoplastic breast resection with local perforator flaps. Tumors of female reproductive system. 2022;18(1):20–24. (In Russ.). https://doi.org/10.17650/1994-4098-2022-18-1-20-24

19. Tekdogan B, Martineau J, Scampa M, Kalbermatten DF, Oranges CM. Oncoplastic reduction mammoplasty: Systematic review and proportional meta-analysis of surgical outcomes. J Plast Reconstr Aesthet Surg. 2024 Feb;89:86–96. https://doi.org/10.1016/j.bjps.2023.11.052

20. Martineau J, Tekdogan B, Lam GT, Correia D, Giordano S, Kalbermatten DF, Oranges CM. Oncological and Surgical Outcomes of Oncoplastic Reduction Mammoplasty: A Single-centre Retrospective Study. In Vivo. 2024 Nov-Dec;38(6):2820–2826. https://doi.org/10.21873/invivo.13762

21. Rutherford CL, Barker S, Romics L. A systematic review of oncoplastic volume replacement breast surgery: oncological safety and cosmetic outcome. Ann R Coll Surg Engl. 2022 Jan;104(1):5–17. https://doi.org/10.1308/rcsann.2021.0012

22. Ahmed GA, Baron DH, Agrawal A. Oncologic and cosmetic outcomes of oncoplastic breast-conserving surgery after neoadjuvant systemic therapy: systematic review and meta-analysis. Breast Cancer Res Treat. 2025 Jan;209(2):229–252. https://doi.org/10.1007/s10549-024-07566-6

23. Daoud A, Vignaroli KA, Malkoc A, Mamoun L, Cerceo JR, Perez K, et al. Oncoplastic Breast-Conserving Surgery Outcomes in the Hispanic Population at a Large County Hospital. Cureus. 2025 Mar 2;17(3):e79932. https://doi.org/10.7759/cureus.79932

24. Nanda A, Hu J, Hodgkinson S, Ali S, Rainsbury R, Roy PG. Oncoplastic breast-conserving surgery for women with primary breast cancer. Cochrane Database Syst Rev. 2021 Oct 29;10(10):CD013658. https://doi.org/10.1002/14651858.cd013658.pub2

25. Brown CA, Mercury OA, Hart AM, Carlson GW, Losken A. Secondary Surgeries After Oncoplastic Reduction Mammoplasty. Ann Plast Surg. 2021 Dec 1;87(6):628–632. https://doi.org/10.1097/sap.0000000000002872