General Medical

Oncoplastic Surgery: When Is It the Right Choice?

Lately, there’s been a new buzzword surrounding the surgical treatment of breast cancer: oncoplastic surgery. It’s an updated way of describing an old tradition—the breast cancer surgeon and reconstructive surgeon working closely together to plan a patient’s breast cancer surgery with immediate reconstruction. These highly skilled surgeons perform their surgery at the same procedure while the patient remains under anesthesia.

(Graphic: Johns Hopkins Medical Center)

Here’s one example: a breast reduction following a lumpectomy. This involves removing the tumor and immediately reconstructing the area by reducing and lifting the breast, for a vastly improved cosmetic result. Another example: a mastectomy with nipple preservation, followed by immediate reconstruction.

Over the decades, the surgical treatment of breast cancer has become more minimally invasive and less disfiguring. As screening techniques have improved, breast cancers are being diagnosed at earlier stages, when they’re much smaller. These patients have many surgical options available to them. Some of these approaches were first introduced in the late 1990s, with two goals: to improve the cosmetic results and quality of life, but most importantly, to reduce the risk of the tumor recurring in the breast.

But there’s been some controversy as to when oncoplastic surgery is appropriate, and for which patients. Many believe that by bringing aesthetics into the mix at the time of the cancer surgery, the cancer surgery itself may be compromised, lowering the odds for longterm survival. At a conference I recently organized on this topic, sponsored by The Leir Charitable Foundations and held at The Leir Retreat Center in Ridgefield, Connecticut, our nationally renowned speakers concluded that oncoplastic techniques are safe in appropriately selected patients when treated by a skilled team of both a surgical oncologist and a reconstructive surgeon.

When considering oncoplastic surgery, the key question is, What makes for an ‘appropriately selected’ patient, and would I fall into that category? Speakers at the conference agreed on the following factors: tumor size and location, breast size, and the surgeon’s ability to remove the tumor with adequate margins.

As with all relatively new surgical techniques, oncoplastic breast cancer surgery will need to be thoroughly studied to evaluate its safety and benefits over the long term. If you’re considering oncoplastic surgery for breast cancer, it’s important to discuss all the relevant factors with your breast cancer surgeon and reconstructive surgeon.

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