Oncoplastic breast surgery – the evolution of plastic surgery and breast oncology

Oncoplastic breast surgery

Historically breast cancer surgery was not focussed on the cosmetic appearance of the breast. Fortunately the aesthetic approach to breast cancer treatment called oncoplastic breast surgery offers the possibility of an improvement in the shape and appearance of breasts.

BREAST CANCER SURGERY

Breast cancer is the number one cause of cancer among women in South Africa. The surgical care of breast cancer has evolved over the years from radical and extensive removal of all breast tissue to less aggressive removal of the affected lump or segment of breast tissue.

This type of surgery is known as breast-conserving surgery, and is always combined with radiation treatment. This combination is important to minimise the chance of a recurrence in that breast. This ensure similar effective cancer treatment as a mastectomy (which is the compete removal of all breast tissue).

Limiting the extent of surgery through breast-conserving surgery to the affected breast, can be a good choice for women who want to preserve sensation to the nipple, or for women who want to breast feed later in life, and for ladies with symptomatic heavy or sagging breasts.

IMPROVED BREAST AESTHETICS

You may be surprised that breast cancer surgery can actually improve the shape and appearance of your breasts. Oncoplastic breast surgery is rooted in the principles of cosmetic breast reduction surgery. It was born out of a need for better cosmetic results after breast cancer surgery.

The beauty of oncolplatic breast surgery is that is uses a multidisciplinary approach, the reconstructive plastic surgeon and breast cancer surgeon work as a team, collaborating on a strategy to remove the cancer in a way the preserves as much breast tissue and skin as is safely possible.

The plastic surgeon uses specialized reconstructive techniques to reshape and contour the breast. Oncoplastic breast surgery also aims to prevent excessive scarring and deformities, helping to produce an aesthetically pleasing breast after treatment.

In sagging or droopy breasts an oncolplastic mastopexy will give a more uplifted and shapely breast. For large and heavy breasts an oncoplastic breast reduction will result in a more comfortable size and shape that suits the figure better. In smaller breasts plastic surgery techniques such as perforator flap surgery or microsurgery is used to achieve a good cosmetic outcomes with breast-conserving surgery.

ONCOPLASTIC BREAST SURGERY

Oncoplastic breast surgery is done at the time of the initial surgery to remove the breast cancer. It is done under general anaesthetic. The length of the surgery and the recovery period is often shorter than other breast reconstruction options such as using breast implant reconstruction or own-tissue reconstruction.

Delayed oncoplastic breast surgery also known as corrective breast surgery can be done to restore the breast to a more natural appearance. This is useful in patients who have had previous breast cancer surgery that resulted in an abnormal breast appearance.

It is of course important to highlight the fact that not all breast cancers are the same. Oncoplastic breast surgery is not suitable in all situations. But when appropriate oncoplastic breast surgery can be a kind of silver lining to breast cancer.