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Principles of Breast and Oncoplasty | Bristol Health News

By Bristol Health

October 23, 2018

The diagnosis of breast cancer is a life-changing experience. Not only does it bring women face to face with questions about survival, they must also undergo surgical treatment for breast cancer. The changes from breast surgery may alter a woman’s perception of physical, emotional, and sexual wholeness.

The scope of a breast surgeon involves strong commitment to the evaluation and care of patients with diseases of the breast and breast malignancies.

Oncoplastic breast surgery combines the principles of breast cancer surgery and plastic surgery to achieve a superior aesthetic result.Most often breast conservation therapy, with lumpectomy and radiation, yields satisfactory cosmetic results.

However, it is reported that 20-30 percent of patients are dissatisfied with the appearance of their breasts after treatment.Oncoplastic Surgery involves using plastic surgery techniques for immediate reshaping of the breast after a “wide excision”/“lumpectomy” for breast cancer.

These techniques are utilized by surgeons who specialize in breast surgery through a fellowship program in breast or surgical oncology and also by general surgeons who have been doing breast surgery for a long time.The process of preservation of the breast contour starts at the time of surgery.

In some cases, plastic surgeons are consulted for surgical decision making and approach.The goals of breast conserving surgery are the removal of breast cancer with an adequate surgical margin and maintenance of a breast that is cosmetically acceptable to the patient.

Part of the “oncoplastic” approach is the surgical management of the unaffected breast for bilateral breast symmetry. Choosing the best surgical approach for a given patient depends upon the breast cancer features, the woman’s breast size and shape, and the surgeon’s skill.

Today, we know that oncoplasty improves psychosocial well being and allows a woman to live fully beyond breast cancer surgery. It’s primary goal is to create form and symmetry by correcting the surgical defect, while ensuring patient safety and health.

Steps taken to design an oncoplastic procedure are:
1. Careful planning of skin incisions and tissue removal.
2. Adequate reshaping of the breast.
3. Repositioning the nipple and areola.
4. Surgery on the unaffected breast for symmetry.

A woman psychologically identifies with her breast, which is important to her sexual image and her relationship with others, within our culture. Thankfully we have moved away from mutilating surgeries for a cancer that has good survival compared to most other cancers.

Thanks to social media, our awareness about breast cancer has improved. More women are having regular screening mammogram, which means that radiologists are more often detecting smaller tumors. With oncoplastic techniques, these smaller tumors can be safely removed with good cosmetic outcomes.

With improved survival rates in breast cancer, it is important for women to feel good about themselves and their bodies. This can be achieved with oncoplastic breast surgery.