Oncoplastic Breast Surgery

Oncoplastic breast surgery combines breast cancer surgery skills with plastic surgery techniques to achieve good cancer control and aesthetic and functional outcomes. Oncoplastic breast surgery provides several benefits for patients including:

• Complete tumour resection + reconstructive surgery
• Maximising treatment effects + minimising side effects
• Improved survival + improved survivorship

By 2040 it’s predicted that there will be more than 400,000 breast cancer survivors in Australia. With increasing patient survival rates, the aesthetic outcome has now gained more importance as an endpoint in breast cancer treatment.

Physical appearance and psychological body image are crucial with regard to a patient’s quality of life. It has been shown that a better aesthetic outcome after breast cancer treatment improves the post-treatment psychological recovery. Therefore, aiming for the best aesthetic outcome is integral to all modern breast cancer surgeries and has become part of the standard of care in the management of breast cancer patients.

How can oncoplastic surgery help with breast cancer management?

Oncoplastic surgery utilises modern techniques delivering the following benefits for patients:

• Hiding the surgical scars 
• Achieving a higher breast conservation rate and reducing mastectomy rate
• Achieving a higher rate of clear margin and reducing reoperation rate
• Reducing early and delayed complications of breast cancer surgery   
• Reducing the chance of breast deformity and asymmetry

How can oncoplastic surgery help address treatment side effects?

In cases where there is a defect in the breast after the removal of cancer, oncoplastic breast surgery can provide:

• Rearrangement of breast tissue and using therapeutic mammoplasty techniques 
• Replacement of tissue with tissue borrowed from outside the breast using perforator flap techniques

How can a multidisciplinary approach help with breast cancer management?

Traditionally patients who required chemotherapy were given the treatment after surgery. Nowadays, all cancer patients are reviewed in a multidisciplinary setting before surgery; and eligible candidates may receive chemotherapy before surgery, also known as neoadjuvant systemic therapy.

What are the advantages of neoadjuvant systemic therapy?

• De-escalation of treatment, which means less extensive surgery will be required 
• Accessing response to treatment 
• Provides time for:
  • Genetic Testing 
  • Decision making about surgical options

What is Personalised breast cancer treatment?

A multidisciplinary approach to patient care is more dynamic allowing for personal attributes to be taken into consideration when developing a breast cancer management plan for a patient. Typically, the following factors are considered when deciding on the most appropriate oncoplastic surgical approach:

• Patient factors
  • Physical
  • Psychological
  • Genetic
  • Fertility
• Cancer factors
  • Tumor biology
  • Tumor burden
• Breast factors
  • Size
  • Ptosis
  • Symmetry
  • Density
  • Patient’s desire

As these factors are varied from one patient to another, the treatment options can be quite different. That is why family or friend's experience may not apply to a newly diagnosed breast cancer patient.  Each patient has a unique treatment journey, and the best person to guide this journey is the treating team familiar with all aspects of the diagnosis and treatment.