Breast cancer patients deal with more than the realities of battling a life-threatening disease. There are challenges with self-image and self-worth issues to process as well. While breast preservation in cancer patients is now a common procedure, there may be significant cosmetic issues, especially following a large lumpectomy.
Oncoplasty represents the integration of plastic surgery techniques into breast cancer surgery to achieve aesthetic and cosmetic results, enhancing quality of life of the patients, without compromising control of disease.
In this relatively new surgical specialty, the whole woman is treated, not just the cancer. With oncoplastic surgery, the cancer is removed and the cosmetic reconstruction is performed during the same procedure – a whole new approach to treating breast cancer.
In the first portion of the surgery, the cancer surgeon removes the tumor. The plastic surgeon then steps in to perform surgery on the breasts to make them more symmetrical, addressing any cosmetic Issues as a phase of the surgery.
The cosmetic portion of the surgery is very similar to a breast reduction or breast lift procedure that might be performed on a cancer-free patient. Breast tissue is removed from the healthy breast to make it more symmetrical with the affected breast, both breasts are re-contoured, and both nipples are moved upward. The breasts are then somewhat smaller, but are lifted, achieving a more youthful appearance – a residual benefit, particularly in the cases of older woman. If the nipple has been affected by the cancer, a new nipple may be constructed.
Research has shown that lumpectomies (surgical removal of just the cancer with a surrounding cuff of normal breast) are just as effective in treating many breast cancers as the more disfiguring radical mastectomy (removal of the entire breast, skin, and other tissues). Since most early-stage cancers are now treated with lumpectomy, Every one of these patients is a potential candidate for the combined oncoplastic procedure.
Every patient will have different needs, depending upon her breast size, the size of the tumor, her self-image, and her goals. The oncoplastic surgeon works side-by-side with the cancer surgeon to develop an individualized treatment plan. The large majority of breast cancer patients are candidates for oncoplastic surgery, but every case is unique. Careful evaluation, communication, and cooperation between the patient, the oncology team, and the surgical team will ensure the best outcome for each individual patient.
An important benefit of oncoplastic surgery is the requirement for only one surgical procedure. In most cases, because only one surgery is needed, radiation therapy can be started sooner, instead of delayed to allow time for healing of a second procedure. Also, while the risks of surgery – such as anesthesia complications, infections, or bleeding, are relatively low, They do occasionally occur. Elimination of the need for subsequent surgery can eliminate these risks entirely.
What about the years following the surgery? Does oncoplastic surgery make diagnosing recurrences or new cancers more difficult? There is no evidence that oncoplastic patients are any different than those who have had a traditional lumpectomy, followed weeks to months later by reconstructive surgery. Outcomes are identical in terms of the cancer recurrence and survival, and any risks associated with a second surgical procedure are eliminated.
Women with breast cancer should work closely with their health care providers and inquire about oncoplastic techniques that may be appropriate for them.