Oncoplastic surgery

August 2010

Oncoplastic surgery is a term that describes the use of plastic surgery techniques to reshape the breast to produce an excellent cosmetic result together with effective cancer surgery. Our first objective is always to treat the cancer in the best way possible and cosmetic concerns should not compromise this goal.

In the past surgeons have usually simply removed a segment of the breast with a surrounding margin of healthy tissue and little or no effort has been made to reshape the tissue. With suitable training specialist breast surgeons can use plastic surgery techniques to improve access to the cancer, remove a wider area of tissue and to reshape the breast.

In women with large, heavy breasts for example, cancer surgery can be combined with a breast reduction. Women with large breasts have often considered breast reduction already but put off the idea either because of costs or because they did not want to undergo a procedure that they saw as unnecessary cosmetic surgery. Whilst no one welcomes a diagnosis of breast cancer this does provide an opportunity to create a good outcome from a bad situation. Reduction surgery allows for wider clearance around the cancer. In some situations reduction may involve removing more than a kilogram of breast tissue from each side!

View case example

This option needs to be considered at the time of diagnosis. Getting the bad news that a lump is malignant creates stress and anxiety. A first reaction is often one of urgency - to get on with treatment and to remove the whole troublesome breast. It is important to realise that there is no need or benefit to be gained from rushing into surgery. Cancers develop rather slowly over months and years and significant changes will not progress in a few days.

Following successful breast conserving surgery you will need to have a course of radiotherapy to the breast to reduce the risk of recurrence of the cancer. It is easier to position the breast and administer radiotherapy after breast reduction as there is less tissue to deal with and this is an added benefit.

 
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Trevor Smith MBChB FCS

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