简单保乳手术（sBCS）在技术上发展成为肿瘤成形手术（OBP），以避免乳房切除手术并改善乳腺癌患者的心理社会福利和美容结果。尽管OBP耗时和昂贵，但我们正在目睹其使用的增加，甚至是对于可以使用sBCS治疗的病例。在简化和选择更复杂的肿瘤成形手术之间进行选择是困难的。本次综述提出了一种实用的方法来帮助做出这种决定。医学文献表明，OBP和sBCS在局部复发和总体生存方面可能是相似的，并且与sBCS相比，患者对OBP的美学结果更满意。然而，缺乏全面的高质量研究，评估它们的安全性、有效性和患者报告的结果，这些假设结论受到阻碍。 OBPM手术后并发症可能会延迟辅助放疗的启动。此外，尽管进行手术夹针置入，但是乳房容量的精确定位并没有得到很好的记录，使得放射肿瘤学家难以进行精确的剂量递送，而在OBP复杂病例中，WBRT优先于APBI。在对财务毒性、患者满意度和肿瘤学结果进行严格评估的基础上，应谨慎地将OBP纳入临床实践中。提供知情同意的周到方式对于在sBCS和OBP之间做出决定是至关重要的。随着我们展望未来，机器学习和人工智能有可能帮助患者和医生通过设置现实的美学期望来避免术后后悔。版权所有©2023 Elsevier Ltd.

Simple breast conservation surgery (sBCS) has technically advanced onto oncoplastic breast procedures (OBP) to avoid mastectomy and improve breast cancer patients' psychosocial well-being and cosmetic outcome. Although OBP are time-consuming and expensive, we are witnessing an increase in their use, even for cases that could be managed with sBCS. The choice between keeping it simple or opting for more complex oncoplastic procedures is difficult. This review proposes a pragmatic approach in assisting this decision. Medical literature suggests that OBP and sBCS might be similar regarding local recurrence and overall survival, and patients seem to have higher satisfaction levels with the aesthetic outcome of OBP when compared to sBCS. However, the lack of comprehensive high-quality research assessing their safety, efficacy, and patient-reported outcomes hinders these supposed conclusions. Postoperative complications after OBP may delay the initiation of adjuvant RT. In addition, precise displacement of the breast volume is not effectively recorded despite surgical clips placement, making accurate dose delivery tricky for radiation oncologists, and WBRT preferable to APBI in complex OBP cases. With a critical eye on financial toxicity, patient satisfaction, and oncological outcomes, OBP must be carefully integrated into clinical practice. The thoughtful provision of informed consent is essential for decision-making between sBCS and OBP. As we look into the future, machine learning and artificial intelligence can potentially help patients and doctors avoid postoperative regrets by setting realistic aesthetic expectations.Copyright © 2023. Published by Elsevier Ltd.