#oncoplasticsurgery

Oncoplastic surgery is a breast reconstruction procedure that has increased in popularity in Singapore, especially among patients with early stage breast cancer. This trend has been specifically noted in the 2010-2014 Interim Annual Report on cancer incidence trends in Singapore. The procedure itself is a boon to women, who are dreading the loss of their sexuality and femininity that accompanies the deformation of their breasts following a lumpectomy.

An Overview of Oncoplastic Surgery

During a lumpectomy, the breast surgeon removes the lump and a margin of breast tissue surrounding it. This leaves a gaping cavity within the breast. If left untreated, the cavity collapses and starts pulling breast tissue and the overlying skin toward it. This causes deformities in the breast, such as puckering of surgical scars, loss of breast contour, and nipple deviation.

In order to prevent these deformities from developing, a breast reconstruction surgeon—specifically known as an oncoplastic surgeon—steps in after the lumpectomy and a quick pathology report is done in order to reconstruct the affected breast.

How Oncoplastic Surgery Is Done

Prior to the lumpectomy, the oncoplastic surgeon already discusses the patient’s problem with the breast surgeon. Factors to be considered include the size of the tumour and the potential deformities that can occur.

During the oncoplastic surgery itself, the surgeon reshapes the breast through the displacement and redistribution of breast tissue into the cavity that is left behind by the removed tumour. If drooping in the breast can be expected following lumpectomy, the oncoplastic surgeon reduces the breast volume through a procedure called Therapeutic Mammoplasty. If the woman has a big breast and drooping is expected, the surgeon performs breast volume reduction and higher repositioning of the breast through a procedure called Therapeutic Mastopexy. So that both breasts will be symmetrical, the oncoplastic surgeon may perform a breast lift or reduction on the opposite breast.

One problem that is encountered with oncoplastic surgery is the preservation of the blood supply to the nipple. In these cases, the nipple is first removed and then put back on the breast after breast reduction or lift, much like a skin graft. However, the side effects include the loss of breastfeeding ability and nipple numbness.

Benefits of Oncoplastic Surgery

There are a number of benefits to having oncoplastic surgery:

Both the lumpectomy and oncoplastic surgery are done on the same day, so they can count as one surgery.

Allows for the removal of larger tumours and tissues, especially if there are concerns about the extent of the clear margins of the tumour

With the removal of large amounts of breast tissue, oncoplastic surgery done on the other breast allows for the creation of better symmetry between the two breasts

Women who have complaints about having large breasts experience relief after surgery

Surgery is considered complete prior to the institution of radiation therapy. This prevents the development of wound-healing problems associated with post-radiation surgery.