Clinical application of Level II volume displacement techniques in oncoplastic breast-conserving surgery: a Chinese single-center retrospective analysis with patient-reported outcomes.

[BACKGROUND] In Chinese breast cancer patients, conventional breast-conserving surgery (BCS) often results in suboptimal cosmetic outcomes due to smaller breast volume and high tumor-to-breast ratios. Although oncoplastic breast-conserving surgery (OPS) has improved aesthetic outcomes in Western populations, its application in China remains limited. This study aims to address this gap by evaluating the safety, feasibility, and patient-reported outcomes of Level II volume displacement OPS techniques in Chinese women with small to medium-sized breasts.

[METHODS] A retrospective analysis was conducted on 120 patients treated at a single center in China. Sixty patients underwent Level II volume displacement OPS, while the remaining 60 received conventional BCS. A comprehensive surgical protocol was established, including patient selection criteria, a decision-making flowchart for technique choice, and detailed procedural steps for each approach. Postoperative outcomes were assessed using the BREAST-Q questionnaire, evaluating breast satisfaction, psychosocial well-being, and sexual well-being.

[RESULTS] In the OPS group, most patients had small to medium-sized breasts (18.3% size A, 33.3% size B, 33.3% size C), with resection volumes ranging from 15 to 40% of breast tissue. The most frequently used techniques were Racquet, Round Block, and Bat-Wing approaches, which were particularly effective for smaller breasts requiring relatively large tissue resections. Reduction mammoplasty (inverted T or vertical-scar techniques) and contralateral symmetry procedures were rarely required. Compared to the BCS group, OPS-treated patients reported significantly higher BREAST-Q scores for breast satisfaction, psychosocial well-being, and sexual well-being ( P < 0.001). Complication rates were low and comparable between the two groups (OPS: 10% vs. BCS: 13.3%).

[CONCLUSION] Level II volume displacement OPS techniques are safe and effective for Chinese patients undergoing moderate-volume resections, providing superior aesthetic results and improved quality of life. This study offers a practical and adaptable framework for selecting and performing OPS in patients with small to medium-size breasts, supporting wider adoption in China and similar clinical settings.