Oncoplastic breast surgery combines the techniques of traditional breast cancer surgery with the cosmetic advantages of plastic surgery. The goal is to remove cancer while minimizing the unwanted effects of surgery, helping patients heal both physically and emotionally.
Sarah Persing, MD, MPH specializes in breast oncology, oncoplastic surgery, microsurgery and general plastic reconstructive surgeries at Tufts Medicine. She performs oncoplastic breast surgery at both Tufts Medical Center and MelroseWakefield Hospital.
Dr. Persing answered some common questions about oncoplastic breast surgery.
Q. Can you briefly describe what oncoplastic surgery is?
A. Oncoplastic breast surgery involves combining the removal of the breast cancer using a plastic surgery design or techniques at the same time of the breast conserving surgery by using the patient’s own tissue. These procedures may be performed only on the breast with cancer using local and regional tissue or on both breasts for symmetry.
An example of this would be a patient who has breast cancer with very large breasts and symptoms related to her large breasts. For this patient, a breast reduction design could be used to remove the breast cancer and also reduce the size of her breasts at the same time. A symmetry procedure for the other unaffected breast may also be performed at the time of surgery as well.
Q. How is oncoplastic surgery different from more traditional types of breast cancer surgery?
A. The traditional surgical management of breast cancer involves either breast conserving surgery (lumpectomy or partial mastectomy) or mastectomy (removal of the breast). Oncoplastic breast surgery is a type of breast conserving surgery that uses a plastic surgery design to perform the lumpectomy. Oncoplastic breast surgery helps to minimize the contour deformity of the breast following lumpectomy and can also improve the quality of life for patients.
Q. Is everyone undergoing breast cancer surgery a candidate for oncoplastic surgery?
A. Patients who are candidates for breast conserving surgery may be candidates for oncoplastic breast surgery.
Q. What are some of the benefits of oncoplastic surgery?
A. Oncoplastic breast surgery has many benefits.
- Patients undergoing oncoplastic breast surgery will receive the standard of care for breast-conserving surgery for their breast cancer with the added benefit of improving the contour and symmetry of their breasts following the breast-conserving surgery.
- Oncoplastic surgery enables the surgeon to remove more breast tissue to reduce the chances of having to go back and do more surgery to remove the cancer.
- Oncoplastic surgery produces better outcomes in terms of cancer removal. Positive margin rates, or cancer not removed with oncoplastic breast surgery is 5-10% compared to 20-40% with standard lumpectomy.
- Oncoplastic surgery has also been shown to have higher patient satisfaction scores compared to standard lumpectomy and mastectomy with reconstruction. For patients with multiple cancers in the breast that would typically require a mastectomy, oncoplastic surgery may be performed to preserve their breasts.
- Oncoplastic surgery has been shown to be safe with similar recurrence rates and survival rates compared to standard lumpectomy and mastectomy.
Q. Does the reconstructed breast look + feel similar to the pre-surgery breast?
A. Oncoplastic breast surgery is a form of breast-conserving surgery that uses the patient’s own breast tissue for reconstruction. The goal is to remove the breast cancer and maintain the look and feel of a natural breast.
Q. Is the recovery from oncoplastic surgery longer/harder?
A. The typical recovery from surgery is six weeks before the patient can resume exercising and all other activities, but patients usually feel mostly back to normal after approximately two weeks. The surgery typically takes an additional one to three hours longer than a standard lumpectomy, but this depends on the type of reconstruction performed.
