2025 International Symposium on Breast Diseases of Inland São Paulo: oncoplastic surgery in breast cancer treatment
DOI:
https://doi.org/10.29289/2594539420250029Keywords:
breast neoplasms, oncoplastic surgery, mammaplasty, breast reconstruction, radiotherapy, adjuvant, inflammatory breast neoplasmsAbstract
Introduction: Oncoplastic surgery has become an essential component of breast cancer management, aiming to balance oncologic safety with aesthetic outcomes. However, controversies persist regarding its application in specific clinical scenarios, such as multicentric tumors, implant-based reconstruction in the context of adjuvant radiotherapy, and reconstruction after inflammatory breast cancer with optimal response. Methods: This study reports the clinical guidelines established during the 2025 International Symposium on Breast Diseases of Inland São Paulo. A total of 110 panelists participated, including 99 mastologists (90%) and 11 breast cancer–related specialists (pathologists, breast imaging specialists, radiotherapists, and clinical oncologists; 10%). Four priority topics were addressed through evidence-based lectures, followed by structured technical discussions and anonymous electronic voting. Consensus was defined as agreement ≥75%. Results: Sectoriectomy with oncoplastic techniques was preferred for the management of multicentric tumors (65%), although consensus was not achieved. Prepectoral implant-based reconstruction was the most frequently selected option (53%), also without consensus. Consensus was reached regarding the use of definitive implants in patients undergoing adjuvant radiotherapy (80%) and the absence of an absolute contraindication to breast reconstruction in cases of inflammatory breast cancer with optimal response to systemic therapy (84%). Conclusions: These guidelines reflect contemporary oncoplastic practice, emphasizing breast preservation, oncologic safety, and aesthetic outcomes. The use of definitive implants in the setting of adjuvant radiotherapy and breast reconstruction after inflammatory carcinoma with optimal response is supported by consensus. In contrast, the management of multicentric tumors and implant positioning remains individualized, underscoring areas where further prospective research is needed.
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Copyright (c) 2026 Eduardo Carvalho Pessoa, Fabio Bagnoli, Marcelo Madeira, Joaquim Teodoro Araujo Neto, Giuliano Mendes Tosello, Fabricio Brenelli, Beatriz Baaklini Geronymo, Daniel de Araujo Buttros, Evandro Fallaci Mateus, Natalie Rios, Renata Suzuki Brondi, Ricardo da Costa Pinto, Augusto Tufi Hassan
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