What is oncoplastic surgery?
Oncoplastic surgery applies plastic surgery principles to the surgical treatment of breast cancer. Rather than simply cutting out the tumour and closing the wound, the surgeon also reshapes the remaining breast tissue at the same time to achieve the best possible appearance.
The goal is to remove the cancer with clear margins, the oncological part, while also ensuring that the breast looks as natural as possible after surgery, the plastic surgery part. Done well, oncoplastic surgery widens the scope of breast-conserving surgery, enabling it in cases where a standard lumpectomy would leave a visible deformity.
Types of oncoplastic surgery
Volume displacement techniques reshape the remaining breast tissue by moving local tissue into the defect left after tumour removal. They are suited for patients with medium to large breasts where there is enough tissue to rearrange. A reduction mammoplasty (breast reduction) pattern is often used, which also lifts and shapes the breast. The opposite breast may be reduced simultaneously to achieve symmetry.
Volume replacement techniques bring in tissue from outside the breast to fill the defect. Techniques such as the chest wall perforator flap, LD mini-flap, or thoracoepigastric flap replace the removed volume with adjacent tissue. These are used when there is not enough local tissue for rearrangement, or when the defect is in a location that would be difficult to fill with displacement alone.
When it is recommended
- Patients who want breast-conserving surgery but have a tumour in a location or size that would leave a visible defect after standard lumpectomy
- Patients with large breasts where a wide excision can be combined with a breast reduction for both oncological clearance and improved breast shape
- Patients where the volume removed would be more than 20% of the breast
- Re-excision after incomplete margins where additional reshaping is needed
Outcomes
Multiple published studies have shown that oncoplastic surgery achieves comparable oncological safety to standard lumpectomy, with significantly better cosmetic outcomes. Patients report higher satisfaction with breast appearance after oncoplastic surgery compared to standard wide local excision.
For patients with large breasts who have a breast reduction as part of the oncoplastic procedure, there is an additional benefit: a reduction mammoplasty improves quality of life by reducing the weight, backache, and skin issues associated with large breasts.
Oncoplastic surgery requires a surgeon trained in both oncological breast surgery and plastic surgery principles, which is exactly what a Fellowship in Breast Oncoplastic Surgery provides. This is a specific and specialist qualification that Dr. Shruthi holds.