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Is Breast Reconstruction Only for Patients Who Need a Mastectomy?

Posted August 04, 2021 in Breast Cancer, Breast Reconstruction

3 Minute Read: 

Not always! 

Some breast cancers are treated with a lumpectomy, or more limited removal of a tumor, to preserve the breast. This is called “breast conservation therapy” and is almost always paired with subsequent radiation to treat breast cancer effectively. 

Woman holding a pink breast cancer ribbon in front of chest.

Not all women and not all cancers can be managed with breast conservation. For instance, if a tumor is very big, or there are multiple tumors, a breast surgeon may recommend a mastectomy to ensure the cancer is removed completely. 

Still, breast conservation therapy is a very safe and effective way to manage breast cancer for many women. And, as an added advantage, the patient keeps (most of) her breast, which tends to preserve a natural appearance and benefit a healthy body image. 

The extent of surgery and recovery is also less as compared to a mastectomy.

Now there is a catch sometimes. Even after a limited lumpectomy, some women develop distortion or even deformity of their breast shape. 

In other cases, significant breast asymmetry can develop. These patients will sometimes seek out a plastic surgeon to improve upon these concerns after they develop. 

But what if we could identify patients at greater risk of shape issues beforehand?! 

What Is Oncoplastic Reconstruction?

Some women undergo lumpectomy with a reshaping procedure during the same operation. This is termed “oncoplastic reconstruction” and is a team effort between the breast surgeon (who does the lumpectomy) and plastic surgeon (who does the reconstruction after). 

An oncoplastic approach is a very common scenario for a larger breasted woman who might have considered a breast reduction in the past. For this type of patient, a breast reduction operation can be strategized such that the tissue removed encompasses the tumor and healthy margins. The end result is a smaller, lifted breast with no cancer. 

The reduction part is replicated on the opposite side to maintain good symmetry. This, all in all, is a good deal!

Before and after results of oncoplastic breast reconstruction

Other scenarios that may benefit from an oncoplastic approach include:
  • Larger tumors
  • Extensive skin resections
  • Medial (inner breast) and inferior tumors

Oncoplastic techniques will often rearrange the remaining breast tissue to fill the space left behind by the tumor resection. Tailoring the skin like a mastopexy or breast lift will generally give a pretty, natural breast shape, well-positioned nipple, and a scar pattern that camouflages well. 

The best and most predictable aesthetic result is achieved when the reshaping is carried out before radiation is delivered since radiation can cause skin and tissue fibrosis and poor wound healing. For that reason, an oncoplastic approach should be considered before the lumpectomy. A consultation with a plastic surgeon can clarify if this type of reconstruction would be advantageous.

Oncoplastic reconstruction is one of the most rewarding operations the surgeons at DAVinci Plastic Surgery perform. Not only do women put their cancer behind them, but they get pretty and lifted breasts in the process. The surgery and recovery are well tolerated — in fact, patients usually go home the same day. These are some of my happiest patients, and this is a very fulfilling part of our practice. 

Interested in Oncoplastic Reconstruction in Washington, DC?

If you are interested in learning about all of your breast reconstruction options in DC, contact DAVinci Plastic Surgery by calling (202) 966-9590 or filling out our online contact form. Dr. Pinell and Dr. Davison will be happy to guide you through the reconstruction process.