oncoplastic Breast Reconstruction

Patients diagnosed with breast cancer currently have two options for surgical management of the disease: mastectomy and lumpectomy (also known as breast conservation therapy).

Patients who are candidates for breast conservation therapy have only the portion of the breast afflicted with cancer removed (along with a margin of uninvolved breast tissue) with the remainder of the breast untouched. This strategy for treating breast cancer has demonstrated equal rates of survival to mastectomy and is the most common breast cancer treatment used today.

However, since this method of selective tissue and subsequent radiation therapy cycles can introduce a host of possible cosmetic deformities in the remaining breast tissue, cosmetic deformities that can arise as a result of breast conservation can include:

  • Retraction of surrounding tissues
  • Painful scars
  • Asymmetry to the breast that was not operated on
  • Wound healing difficulties
  • Infections
  • Alteration of reconstructive options should mastectomy be required in the future

To address these deformities before or after they appear, a new and rapidly growing field in breast reconstruction has been geared at addressing them. This is known as oncoplastics.

A portion of patients can be identified to be high risk for having a poor cosmetic result following conservation surgeries. These patients are actually treated before their lumpectomy and radiation. Through our team approach to breast cancer care, our plastic surgeons work with the breast cancer surgeon to perform procedures at the same time as the lumpectomy to achieve this goal.  Ideal candidates for this procedure are patients:

  • With small breasts who will require large excisions
  • With large, drooping breasts who will require large excisions
  • Who will require multiple excisions on the same breast as part of their treatment

The surgical techniques our plastic surgeons use may involve a form of breast lift or breast reduction and likely a lift or reduction on the normal breast for improved final symmetry.

Patients who have already undergone breast conservation therapy and have a deformity do have surgical options. The ideal reconstruction method for these patients, known as flap reconstruction, involves transferring tissue into the defect that has not been subject to the effects of radiation. The transfer of non-radiated tissue into a deformed breast can restore an aesthetically pleasing shape while improving the feel and sometimes pain associated with a severe deformity.