Increasingly, using oncoplastic techniques allows surgeons to avoid performing a mastectomy and instead offer breast conservation options.
The reason that the aesthetic outcome (and hence oncoplastic surgery) is important is that many studies have shown that women feel more confident, less depressed and view themselves more positively if they feel their breasts don’t look deformed post breast cancer surgery. In addition to this, women with breast cancer are now being treated very successfully which means that they tend to live much longer and, thus, do not want deformed breasts reminding them of their cancer treatment.
If the aesthetic outcome of your breast cancer surgery is important to you, it is vital to consult with an oncoplastic surgeon, who not only is fully familiar with the important principles of breast cancer surgery, but who can also draw on his extensive experience in plastic surgery to plan for an aesthetically acceptable outcome. Although oncoplastic techniques can be employed further down the line after breast cancer surgery, the best outcomes are achieved when the oncoplastic procedure is performed at the same time as the breast cancer surgery, hence the importance of seeing an oncoplastic surgeon. When deciding on which oncoplastic surgeon to see, it is important to select one that has been trained through the National Oncoplastic Fellowship scheme, as they are likely to be able to offer the full range of oncoplastic techniques.
There are a wide range of different techniques used in oncoplastic surgery, all of which are offered by our Consultant Onco Plastic and Reconstructive Surgeon. Some of these include:
This technique involves reshaping the breast tissue that remains after a lumpectomy to disguise the defect that would otherwise arise. It is suitable for small tumours.
This technique allows large tumours to be removed (and thus may prevent the need for a mastectomy). The technique involves reducing the breast to a smaller, more lifted size (similar to a breast reduction). Usually, the unaffected breast is also eventually adjusted to leave a pair of symmetrical breasts. It is a good option for women with larger (D cup or more) breasts. It can be performed as a day case procedure or with a one-night stay. Most patients have recovered sufficiently to drive within five to seven days.
This 42-year-old with a screen-detected breast cancer in the right upper outer breast. This was removed (wire guided) and both breasts were reduced using oncoplastic surgery (bilateral therapeutic mammoplasty) to a C cup.
Local Perforator Flap Volume Replacement
This sophisticated procedure involves recruiting tissue from the lateral (side) or anterior (front) chest wall to replace the volume lost as a result of a lumpectomy. It is an excellent technique for women with smaller breasts and with tumours in the outer and lower half of the breasts. Examples of this technique are LICAP, LTAP & TDAP flaps. Our Consultant Onco Plastic and Reconstructive Surgeon has pioneered this operation in the local area is one of the very few oncoplastic surgeons in the UK who offers this procedure. Typically patients stay in overnight and have recovered sufficiently to drive in a couple of days.
A 45-year-old woman with a 2 cm breast cancer in the outer half of a B cup right breast. The breast cancer was removed by a wide local excision (lumpectomy). The lost volume was then replaced by a LICAP flap.
Lipomodelling (Fat Transfer)
This involves taking fat from one part of the body through liposuction and after processing it, re-injecting it into the area requiring volume replacement following a lumpectomy. It is a good technique for correcting volume defects after breast cancer treatment has been completed and may occasionally need to be repeated a number of times before an ideal aesthetic outcome is achieved. It is a relatively short procedure that may be performed under local or general anaesthesia.
Scarring as a marked indentation in the breast as a result of previous breast cancer surgery and radiotherapy. This was corrected with two rounds of lipomodelling).
To view further examples of oncoplastic surgery, please click here.