Oncoplastic breast surgery is a new cutting edge form of breast reconstruction that is used after a lumpectomy or partial mastectomy. Board Certified Plastic Surgeon Dr. Shareef Jandali has performed over 100 oncoplastic breast reconstructions, one of the largest series in the country. It involves using one’s own remaining breast tissue to reconstruct the defect after a lumpectomy. The word “oncoplastic” is derived from two roots: “onco” which means “cancer” and “plastic” which means “to mold”.
Oncoplastic breast surgery combines the latest techniques from breast lift and breast reduction surgery to allow the remaining tissue of the breast to be moved around to fill in the defect after a lumpectomy or partial mastectomy. These techniques originated in Europe over the last decade and plastic surgeons in the United States are just starting to use them. Traditionally, women with breast cancer would see a breast surgeon who would offer either a lumpectomy and radiation treatment (known as breast conservation therapy) or a mastectomy. Many women opt for a lumpectomy since this saves their breast, unlike a mastectomy in which the entire breast is removed.
After removing part of the breast during a lumpectomy, this leads to an indentation or depression where the cancer and its surrounding tissue were removed. If the lumpectomy is in the lower half of the breast, the nipple can be pulled to the bottom of the breast and scarred down after radiation therapy. Plastic surgeons that have been trained with these cutting edge oncoplastic techniques can move around the patient’s own remaining breast tissue to fill in the defect from the lumpectomy. This allows the breast to heal without a concavity and without pulling and scarring of the nipple downward. If oncoplastic surgery is not performed and these deformities occur, they are difficult to treat after radiation treatment and often involve having to perform a flap from another area of the body.
Oncoplastic breast reconstruction not only fills in the defect after a lumpectomy, but it also lifts both breasts if they have sagged and reduces both breasts in size if they are excessively large.
Oncoplastic surgery allows some women to be able to save their breast after the diagnosis of breast cancer instead of removing the entire breast with a mastectomy. Before oncoplastic reconstruction, women with average sized breasts (C cup) often were not offered a lumpectomy and had to have a mastectomy. Now, with oncoplastic techniques, these women can be offered a lumpectomy, knowing that the defect can be filled by rearranging the remaining breast tissue and maintaining a good cosmetic outcome. This allows them to avoid a mastectomy and implant reconstruction, avoiding the risk of implant infection.
Oncoplastic surgery has been shown in many studies to be very safe. It does not interfere with radiation therapy and often makes radiation treatment easier in women with large and ptotic (sagging) breasts. Studies show that lumpectomies and partial mastectomies combined with oncoplastic reconstruction have a lower chance of having a positive margin than cases without oncoplastic surgery.
Oncoplastic surgery is covered by all insurance companies as a form of breast reconstruction. Insurance companies also cover a lift or reduction on the opposite (non-cancer) breast. This allows the patient to have both breasts lifted or reduced in size so that they are symmetric.
If you are undergoing a lumpectomy or a partial mastectomy in Connecticut or New York and are interested in oncoplastic breast reconstruction, schedule a consultation with Dr. Shareef Jandali today. Dr. Jandali performs a large number of oncoplastic breast reconstructions every year. Call 203-374-0310 to set up an appointment. We look forward to seeing you.