Today, women diagnosed with breast cancer have multiple surgical options to choose from. Historically, breast cancer surgery has been limited to removing the entire breast (mastectomy), or removing the lump (tumor) and preserving the breast. This is known as a lumpectomy, or breast conserving surgery. Advances in surgical techniques, as well as the need for improved breast cancer care, have resulted in the development of oncoplastic breast surgery.
What is oncoplastic breast surgery?
Oncoplastic surgery combines traditional lumpectomy with plastic surgery techniques. Once the tumor has been removed, the breast is reshaped in order to provide the most visually pleasing outcome. Reshaping the breast prevents contour deformities and allows for better cosmetic results. Removal of the tumor and reshaping of the breast are done during the same operation.
Is it safe?
Oncoplastic surgery does not compromise your cancer care. Safe treatment of breast cancer is always our number one priority. The goal is to remove the tumor with clear margins, the same as in traditional lumpectomy operations. Radiation treatment is generally recommended following oncoplastic breast surgery, just as in standard breast conserving surgery. Studies comparing traditional breast conservation and oncoplastic surgery have shown comparable outcomes. Oncoplastic surgery is equally safe from a cancer perspective.
There is a difference when we compare cosmetic outcomes and quality of life. Women who undergo oncoplastic surgery are more satisfied with the cosmetic appearance of their breasts. This can lead to improved quality of life through better self-confidence, self-esteem, and comfort with intimacy.
What are the possible complications?
As with traditional lumpectomy, complications are possible. These may include bleeding, infection, changes in breast and nipple sensation, wound healing issues, asymmetry, cosmetic dissatisfaction, and need for reoperation.
On occasion, a second operation is needed to treat the cancer. This may happen if the first surgery failed to remove all of the disease. This can happen in any breast cancer surgery, but can be challenging in oncoplastic surgery because the tissue has been rearranged. A larger surgery may be needed to remove the remaining cancer. This may include mastectomy. To avoid this, imaging studies such as mammogram, ultrasound, or MRI may be done before your surgery to fully assess the location and extent of the disease.
What about the opposite breast?
Oncoplastic surgery generally results in a smaller, rounder breast on the operative side. Radiation can further shrink or tighten the breast. To achieve symmetry, the opposite breast can be reshaped or reduced. Surgery on the opposite breast can be done at the time of the cancer surgery, or later on, once all of the breast cancer treatment has been completed.
Which patients are good candidates for oncoplastic breast surgery?
Oncoplastic surgery is ideal for women with moderate to large sized breasts who require a large volume of breast tissue removed. By reducing and reshaping the breasts, some symptoms of macromastia (large, heavy breasts) may be reduced. These include back, neck and shoulder pain, and recurrent rashes under the breast. Most women who have had previous breast surgery are still candidates for oncoplastic surgery.
Women with very small breasts and those who smoke heavily are not ideal candidates for oncoplastic surgery. Oncoplastic surgery is not recommended for women who require mastectomy to safely remove the entire tumor, or for women unable to undergo radiation treatment. Your breast surgeon can help determine if this approach is right for you.
What are my breast surgery options at Nebraska Medicine?
Nebraska Medicine now offers oncoplastic surgery to appropriate candidates, along with multiple other breast cancer surgery and reconstruction options. Remember – treating breast cancer is our main concern. You, along with your breast oncology team, will decide which option works best for you.