As survival rates for breast cancer continue to improve, quality of life becomes more important, and they way that the breast looks after surgery is important. In a study conducted in 2008 33% of conventional breast cancer surgery patients were unhappy with their cosmetic results. Oncoplastic surgery addresses this issue.
Oncoplastic ('onco' meaning 'tumour' and 'plasty' meaning 'shaping' in Greek) surgery is an approach to breast reconstruction that was pioneered in the 1990s in Germany where plastic surgery techniques and breast cancer surgery techniques were combined for the first time in the operating theatre at the time of tumour removal. As a technique it falls under the banner of Breast Conserving Surgery.
Oncoplastic surgery also allows cancer surgeons to remove large tumours with wider margins while maintaining, or in some cases improving the shape of the breast. The benefits of the oncoplastic surgery approach are:
- reduction in mastectomy rates
- reduction in need for re-excision
- reduction in recurrence rates
- the shape of the breast does not deform with radiotherapy
Where a mastectomy is needed, oncoplastic surgery uses various techniques to facilitate the best and most appropriate reconstruction for that individual. Oncoplastic surgery is generally conducted during the same procedure and immediately following the removal of cancerous tissue, which allows for the maximum preservation of breast skin and in some cases the nipple itself. However, oncoplastic reconstruction can also take place in a separate procedure at a later date using autologous (that is, the patient's own body) tissue or an implant.
Whether or not oncoplastic surgery is suitable depends on a number of factors, including the general health of the individual (obesity, smoking, diabetes and connective tissue disorders place a patient at higher risk of wound complications) and the relative size of the tumour to breast size.
As a relatively new discipline oncoplastic surgery is much more technically complex than conventional breast cancer surgery and does require longer procedures than conventional breast cancer surgery.