Breast cancer surgery: Breast reconstruction and oncoplastic surgery

Allow women suffering from breast cancer to preserve their feminine side...

Introduction

Breast reconstruction surgery and oncoplastic surgery are an essential part of breast cancer treatment, which is multidisciplinary, involving many specialists: medical oncologists, chemotherapists, radiation therapists, gynecologists, general and plastic surgeons, psychiatrists.

The aesthetic outcome of breast cancer treatment has become a major concern. However, the treatment of cancer remains the sole priority and aesthetics should never lead to an incomplete treatment.

Surgical treatment of breast cancer has long been based on a binary surgery: lumpectomy or mastectomy.

The lumpectomy or conservative treatment is performed to remove the entire tumor with a margin of safety, without removing the entire breast. However, this conservative surgery can cause a distortion of the breast, or an asymmetric shape and/or volume compared to the other breast. The contributions of plastic surgery to breast cancer surgery have given birth to oncoplastic surgery. This new technique allows wider excision margins and reduces the risk of local recurrence while decreasing iatrogenic sequelae. It also helps to extend the conservative treatment to lesions previously treated by mastectomy, in strict compliance with cancer principles.

Yet, there are still many cases where the complete removal of the breast (i.e. mastectomy) is necessary, such as: multifocal or multicentric cancer, recurrence after conservative treatment, genetic predisposition, large tumor in one small breast, or the patient’s will. In these cases, a breast reconstruction is suggested to the patient based on the strategy of treatment, as each situation requires an appropriate treatment.

Breast reconstruction has no effect on cancer and its safety has been proven. It does not compromise the chances of recovery or the long-term monitoring of breast cancer.

Following the breast reconstruction, the patient often needs time for psychological recovery in the presence of the new breast. For a successful breast reconstruction, it is necessary to integrate this breast within the patient’s body scheme.

The lipofilling or reinjection of autologous fat can be very useful in breast reconstruction for localized retouching.