Italy's Oncoplastic Breast Cancer Surgery Approach: Precision, Aesthetics, and Patient-Centred Outcomes

Italy has emerged as a notable contributor to advances in oncoplastic breast cancer surgery, a specialty that combines oncological cancer removal with plastic surgery reconstruction techniques to achieve both complete cancer treatment and optimised aesthetic outcomes. Researchers and surgeons at leading Italian institutions, including the Fondazione Policlinico Universitario Agostino Gemelli IRCCS in Rome, have developed patient-centred approaches that are redefining what breast cancer surgery can achieve in terms of visible scarring, patient experience, and long-term quality of life.

The Gemelli team published a detailed model called ROME, standing for Radiological and Oncoplastic Multidisciplinary Evaluation, in the Journal of Personalized Medicine in March 2025. The ROME model integrates radiologists, oncologists, surgeons, pathologists, oncoplastic specialists, and psychologists into a single multidisciplinary evaluation framework designed to personalise each patient's surgical plan from the outset. Rather than making aesthetic decisions as an afterthought following cancer removal, the approach embeds aesthetic planning into the initial treatment strategy.

One of the most significant technical advances within this oncoplastic framework is the refined use of nipple-sparing mastectomy and skin-sparing mastectomy, which preserve the breast's natural skin envelope and, in nipple-sparing procedures, the nipple-areolar complex itself. When performed with precise surgical technique and supported by intraoperative frozen section pathology to confirm clean margins, these techniques allow for results where post-surgical visible scarring is dramatically minimised, in some cases to a small incision in the inframammary fold that is largely invisible once healed.

Italian breast surgery has also seen advances in local anaesthesia techniques that in specific cases allow certain procedures to be performed with the patient awake under conscious sedation, particularly for smaller lumpectomies and early-stage tumours where general anaesthesia carries additional risk. This represents an expansion of options particularly relevant for older patients or those with comorbidities who are at elevated anaesthetic risk.

Italy's ANISC, the Italian Society of Breast Surgeons, held its IX National Congress in June 2025, with oncoplastic surgery, robotic-assisted approaches, and minimising scarring as central themes. A published Italian multicentre study on autologous fat grafting for breast reconstruction, reviewing data from 17 Italian breast units, found no significant difference in locoregional recurrence rates between patients who underwent the procedure and those who did not, providing important oncological safety data.

Italy's contribution to oncoplastic breast surgery highlights an important evolution in cancer care philosophy: that oncological outcomes and quality of life outcomes are not competing priorities but can be planned and achieved together. Research from Italian centres has helped validate that wider excisions with oncoplastic reconstruction can achieve lower re-excision rates than standard surgery while producing better aesthetic results.

Sources: Journal of Personalized Medicine (March 2025) | Fondazione Policlinico Universitario Agostino Gemelli IRCCS | IX ANISC Congress 2025 | PubMed Multicentre Italian AFG Study | Revee.news