What is oncoplastic breast surgery?

Oncoplastic surgery combines the traditional methods of breast cancer surgery, such as a lumpectomy or mastectomy, while utilizing specialized plastic surgery techniques to help improve cosmetic outcomes, all within the same procedure. This helps maintain a more natural look and feel of the breast and may reduce the amount of scarring. 

Oncoplastic surgery techniques

  • Hidden scar technique: Your surgeon will place the incision from a lumpectomy in a location that is not visible after fully healing often under the breast, alongside the breast, in the armpit or near the areolar margin.
  • Local advancement flap: In this procedure, your surgeon will take tissue from an adjacent area in the breast or upper abdomen to reform the breast to help match its original appearance. This is also called an “oncoplastic closure.”
  • Bilateral oncoplastic breast reduction: At the time of a lumpectomy, your surgeon, either alone or working with a plastic surgeon, may reduce the size of the healthy breast to better match the side that had the lumpectomy procedure. Sometimes a breast lift (mastopexy) is done at the same time to the breast having the lumpectomy.
  • Skin-sparing mastectomy: This is when the breast tissue, nipple and areola are removed, but much of the skin is spared. It is typically performed when breast reconstruction is planned. The reconstruction can be completed directly after the mastectomy or at a later date (delayed).
  • Nipple-sparing mastectomy: This is most appropriate when there is no cancer found near or in the nipple. The breast tissue, including the ducts, are removed, but the nipple and areola are spared. Like a skin-sparing mastectomy, this is typically performed when breast reconstruction is planned. The reconstruction is most often performed immediately after surgery but can also be delayed.

When is oncoplastic breast surgery appropriate?

Your breast surgeon will discuss if oncoplastic techniques are appropriate for you. Your breast size and shape, as well as the size of the tumor that needs to be removed, will help determine which procedures can be used to treat your cancer.  Some breasts may be too large or too small for specific procedures.  

Will I need other treatment after surgery?

Following your post-operative appointment, your surgeon will help coordinate with other physicians who specialize in medical oncology and radiation oncology to obtain an opinion about those treatments and determine if additional therapy is needed for your individual situation. 

In general, endocrine therapy that blocks estrogen is recommended for most breast cancers after surgery. Additionally, radiation therapy is often recommended after a lumpectomy or limited breast surgery that removed the primary cancer. Other treatments before and after surgery could include chemotherapy, immunotherapy, targeted therapy and brachytherapy.

Is it covered by insurance?

Typically, breast cancer surgery is covered by insurers. However, coverage varies by insurance carrier and plan. Contact your insurance carrier to learn more about your individual coverage.

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