Oncoplastic breast conserving surgery for breast cancer is practical, effective and very desirable in low and middle income country settings, new research study finds.
Safna Naozer Virji MBBS FPBS; 2025 SABCS: Oncoplastic Breast Cancer Surgery Study Reports High Efficacy with Superior Psychosocial Outcomes in a Low or Middle Income Country Setting
An interview with:
Safna Naozer Virji MBBS FPBS
Breast Surgery Fellow, Aga Khan University Hospital, Karachi , Pakistan
SAN ANTONIO, USA—Breast cancer surgeons can deliver high levels of satisfaction to worried patients without sacrificing efficacy in resource-limited settings in a low or middle income country, according to research from Pakistan reported at the 2025 San Antonio Breast Cancer Symposium.
Safna Naozer Virji MBBS FPBS, who is a Breast Surgery Fellow at the Aga Khan University Hospital in Karachi, Pakistan, gave a poster presentation at the conference reporting the outcome of a large series of procedures conducted at her center. Audio Journal of Oncology reporter Peter Goodwin caught up with her at her poster to find out more:
Audio Journal of Oncology: Safna Naozer Virji MBBS FPBS
IN: [Goodwin] “I’m talking now to …
OUT: ……Journal of Oncology. I’m Peter Goodwin
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Source:
Poster Session 2, Day 2: December 10, 2025, San Antonio Breast Cancer Symposium
Presentation number: PS2-03-04
TITLE:
Re-defining Breast Cancer care in an LMIC- a single center study on long term oncological and cosmetic outcomes of Oncoplastic Breast Surgery
SPEAKER:
Safna Naozer Virji, Aga Khan University Hospital, Karachi, Karachi, Pakistan
AUTHORS:
- N. Virji, L. Vohra, S. Khan, I. Khan; Breast Surgery, Department of Surgery, Aga Khan University Hospital, Karachi, Karachi, PAKISTAN.
Background:
Surgical management has greatly evolved from a radical mastectomy to the most recent advancement of a more conservative oncoplastic breast surgery (OBS). It has not only proven to be safe, but also has shown superior cosmetic outcomes compared to standard breast conservation surgery as it is able to address larger and even multi-focal tumors. Nevertheless, this is a relatively novel concept in our developing country with a limited number of professionals trained in the field. Furthermore, there is a financial aspect and stigma to take into consideration. Patients have to pay out of pocket for treatment which deters them from risking the possibility of a second surgery – in case of incomplete resection margins. It also adds the burden on the surgeon to deliver optimal cosmetic outcomes with no intervention to the contralateral breast. The purpose of this study is to determine the long-term oncological and cosmetic outcomes of patients with early-stage breast cancer who underwent OBS at our institution. Methodology: A single-center retrospective study was conducted on adult female patients with biopsy proven Stage I to III breast cancer who underwent OBS from January 2017 to June, 2022. Patients who underwent bilateral breast surgery were excluded. A total of 194 women were eligible for the study and data was extracted from patient records to determine the long term oncologic outcomes— breast cancer recurrence, disease-free survival (DFS), and overall survival (OS). Cosmetic outcomes were evaluated via patient-reported satisfaction using the Harvard breast cosmesis scale, through telephonic interview after obtaining informed verbal consent. The study was approved by the institutional Ethical Review Committee (ERC 2025-11482-34955). Results:
The mean age of women at diagnosis was 48.3 ± 13.2 years with 81% having invasive ductal carcinoma. Sixty-seven percent of the women had hormone receptor positive breast cancer, while 20% had triple negative disease. Among all the patients who were included in the study, half of the patients received neoadjuvant chemotherapy before OBS, followed by adjuvant radiation therapy. Of note, only 6 (3.1%) out of 194 women had a positive margin for which they underwent a second procedure. Level 1 OBS was performed among 77% of the patients. Among those who underwent Level 2 OBS a variety of local perforator flaps were performed. We had a 68% response rate among the patients who were approached via telephone to determine the self-reported cosmetic outcomes, with 91% of the participants reporting ‘Good’ (51%) or ‘Excellent’ (40%) cosmetic outcomes when compared to the contralateral breast. Eight (4.1%) out of 16 patients had an ipsilateral recurrence, while the remaining developed distant metastases. The Kaplan Meier analysis showed that the mean OS of the study participants was 96 months (95% CI=92.2-99.7) since diagnosis, with death as the outcome event. The mean DFS was 93 months (95% CI=89.5 – 97.6) since diagnosis until recurrence as the outcome event. There were significant differences in survival times for patients by recurrence (log rank test, p=0.000) and hormone receptor status (log rank test, p=0.015). There was no significant difference in survival times for patients by type of OBS (log rank test, p=0.860).
Conclusion:
Oncoplastic breast surgery is a safe and effective option for early-stage breast cancer, with low margin positivity and favorable long-term outcomes. Our study demonstrates excellent survival and high patient-reported cosmetic satisfaction, especially with Level 1 OBS. These findings support its broader use—even in resource-limited settings—as a balanced approach to oncologic safety and aesthetic outcomes.
AJOncology[audio mp3="https://www.audiomedica.com/wp-content/2026/01/Safna-Naozer-Virji-SABCS-AJO-PRODUCTION-MASTER.mp3"][/audio], January 16, 2026