Oncoplastic Breast Surgery

What Is Oncoplastic Breast Surgery?

Oncoplastic Surgery involves using plastic surgical techniques to improve cosmetic outcomes in breast conservation surgery and mastectomy. I have just published a detailed blog here.

As breast cancer treatment improves, many women will be expected to live a long time with the cosmetic consequences of breast cancer surgery and improving cosmetic outcomes should be an important consideration of breast cancer surgery.

Integrating oncoplastic techniques into breast conservation surgery can allow wider excision, expanding the limits of breast conservation in some cases, while preventing some of the cosmetic deformities.

What Does Oncoplastic Breast Surgery Involve?

Lumpectomy can often leave the breast with a disfiguring dent. This leads to a large percentage of women being dissatisfied with the cosmetic results of their standard lumpectomy surgery.

Oncoplastic Breast Surgery involves reshaping the remaining or healthy breast tissue or reconstructing the breast after appropriate wide excision of the breast cancer.

Oncoplastic Breast Surgery techniques can result in less trauma for the patient as both the cancer removal surgery and the reconstruction surgery are performed during the same procedure. 

The Oncoplastic Breast Surgery Balance

Careful planning is required as both cancer removal and reconstructive outcomes can add complexity to a delicate procedure.

While the primary outcome is the surgical removal for any breast cancer with a clear margin of tissue, this is also balanced with leaving sufficient breast tissue to avoid significant breast deformation or asymmetric breasts.

Successful surgery can reduce both mastectomy or re-excision rates, and avoid breast deformities.

Considerations Before Breast Cancer Surgery

When faced with breast cancer surgery, your cosmetic outcomes could be regarded as a secondary concern, but where possible, postoperative deformities can be anticipated and avoided.

Often the best time for breast aesthetics to be considered is during the initial surgery as it may be more difficult to correct a deformity, especially after radiotherapy.

Who Are Candidates for Oncoplastic Breast Surgery?

An oncoplastic approach will be considered in every patient. Factors that lead to successful Oncoplastic Breast Surgery are:

Tumour Size

Patients with a favourable breast to tumour size ratio.

The size of the tumour in relation to the size of the breast is the single most important factor when predicting the potential cosmetic result. So a C cup breast with a small tumour is more likely to have a better result than a AA cup patient.

Tumour Location

The location of tumour within the breast is important also. Tumour in the centre, inferior (lower) or medial (inner) parts of the breast, can lead to less acceptable breast conserving surgery resulting in a concave deformity, skin puckering or nipple displacement/deviation.