What oncoplastic surgery is
When a tumour is removed together with a margin of healthy tissue, a cavity is left in the breast. Left to itself, that cavity can cause a dent, asymmetry or a shift of the nipple. In oncoplastic surgery the breast’s own tissue is reshaped in the same session to close that cavity.
In other words, oncoplastic surgery applies breast cancer surgery and breast reshaping techniques within a single procedure. It combines the rules of oncological surgery with the methods of plastic and reconstructive surgery.
The approach also allows the surgeon to remove a wider piece of tissue. Preserving the shape does not mean taking less tissue from around the tumour; clear margins always come first.
Who it suits
Oncoplastic surgery is not applied in the same way in every patient; the surgical plan is drawn up individually. The main criterion is the size of the tumour relative to the volume of the breast. In the assessment we look at:
- The size and position of the tumour and whether it is in a single focus
- Breast volume, shape and the degree of existing sagging
- The stage of the disease and any treatment already given
- Whether you are able to receive radiotherapy after surgery
- Factors affecting wound healing, such as smoking and diabetes
- Your own expectations about appearance
In suitable patients oncoplastic techniques are used together with breast-conserving surgery. When the whole of the breast tissue has to be removed, reconstruction options after mastectomy are assessed instead.
The difference from breast-conserving surgery
The two terms are often confused. One describes how much tissue is removed, the other what is done with the tissue that remains.
The cancerous tumour and the necessary surrounding breast tissue are removed and the rest of the breast is kept. It defines the extent of the operation.
The remaining breast tissue is reshaped once the tumour has been removed. It defines how the operation is carried out, and is most often applied as part of breast-conserving surgery.
Put differently, oncoplastic surgery is a technique that improves the result of breast-conserving surgery. For breast-conserving surgery itself, who it suits and the treatment that follows, see the Breast-Conserving Surgery page.
What to expect after surgery
Swelling and altered sensation in the breast are normal in the first weeks. If the breast has been conserved, the final shape settles within a few months, partly under the effect of radiotherapy, so we do not judge the result by the first month.
If the other breast has been reduced or lifted for symmetry, the two sides may heal at different rates. That evens out with time as well.
Follow-up continues with examinations every six months in the early years and annual imaging. Keeping your check-ups in the same place is preferable, as it makes comparison easier.
Frequently asked questions
Yes. It is the joint use of oncological surgical principles and breast reshaping techniques. The cosmetic result never takes precedence over the cancer treatment.
Not always. In suitable patients it is applied together with breast-conserving surgery. In some patients mastectomy is medically necessary, and reconstruction then comes into play.
No. Suitability is determined by the characteristics of the tumour, the structure of the breast, the stage of the disease and the other treatments planned.
As with any operation, scars form at the incision sites. Their position and appearance depend on the technique used, the structure of the breast and how you heal.