What Is Oncoplastic Surgery in Breast Cancer?
Oncoplastic surgery combines breast rebuilding for esthetic purposes with cancer treatment. The surgeon first removes tissue that has been impacted by cancer. In order to correct any disfigurements following the cancer surgery, either a plastic surgeon or an oncology surgeon performs follow-up surgeries. Surgery on both breasts can be necessary to obtain a more uniform appearance. In order to ensure that patients achieve a feeling of normalcy and confidence in themselves by restoring the natural look and symmetry of their breasts after cancer therapy, oncoplastic surgery prioritizes both effective cancer treatment and cosmetic benefits.
The objective is to treat cancer effectively while producing better, less side effect cosmetic results. Promoting breast conservation surgery over mastectomy wherever feasible was the first significant move in the field of oncoplastic surgery. In order to improve both the cosmetic and oncological elements of surgery, this strategy has evolved into a variety of treatments, including volume replacement, breast reduction, and approaches to seal breast flaws. Preserving the breast should not be the only goal, as esthetic enhancement is also vital.
What Is the Need for Oncoplastic Surgery in Breast Cancer?
Every breast cancer surgery should be regarded as an oncoplastic surgery. A basic skill set that encompasses both cancer therapy and cosmetic considerations is necessary for surgeons. The objective is to give the patient the best possible outcome. In order to get the greatest outcomes, surgeons must comprehend the various mastectomy approaches and how they work with various reconstruction alternatives. Considerations like breast shape, scars, and quality of life should be taken into account while performing even a basic mastectomy. Even in the absence of reconstruction, this strategy can greatly enhance results. Early consideration of reconstruction choices should occur during treatment planning, and mastectomy and rapid reconstruction should be viewed as a team effort.
Who Needs Oncoplastic Breast Surgery?
Oncoplastic procedures are adaptable and can be customized for different types of breasts. However, to achieve the best results from oncoplastic surgery for breast reduction, patients usually require sufficiently large breasts. Smaller-breasted women or those who have had several lumpectomies might not be eligible for oncoplastic surgery in this situation. The patient's breast size and surgical background determine if oncoplastic surgery is appropriate.
What Are the Various Oncoplastic Surgery Techniques?
Patients can have a thorough discussion about prospective reconstructive alternatives with their healthcare professional before they have breast cancer surgery. The medical staff will go over the planned cancer removal surgery procedure and how it can alter the appearance of the affected breast. With this information, patients can make well-informed decisions for breast reconstruction, taking into account their desired post-surgery result, body type, general health, and characteristics of the malignancy. The various oncoplastic surgeries are discussed in detail below:
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Lumpectomy - The goal of a lumpectomy is to remove malignant tissue from the breast while leaving the majority of the breast intact. A surgeon eliminates the cancerous tissue along with a small portion of the surrounding healthy tissue during this procedure. The size and location of the tumor determine how much tissue is removed. The size and form of the breasts may alter after a lumpectomy if breast reconstruction is not done. The main goal of breast reconstruction is restoring the breast to its original symmetry and appearance so that it can be matched to the unaffected breast.
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Bilateral Breast Reduction - Certain lumpectomies result in a notably smaller affected breast. The patient may choose to get a bilateral breast reduction operation under this circumstance. After performing a lumpectomy on the damaged breast, the doctor will make the other breast smaller to match. A similar amount of tissue is removed from the healthy breast during a breast reduction procedure. If one needs to remove a substantial quantity of tissue from the afflicted breast, this is an excellent option. The surgeon will make sure that all of the malignancy is removed and that, following surgery, the breasts appear symmetrical.
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Bilateral Breast Lift - In general, less breast tissue is removed with a breast lift than during a breast reduction. When doing a lumpectomy, the doctor will try to remove the least amount of tissue as feasible. Subsequently, to enhance the symmetry, both breasts have been contoured and moved. As part of this treatment, some people have their nipples relocated.
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Skin-Sparing Mastectomy - A mastectomy rather than a lumpectomy can be necessary if the cancer is advanced. In contrast to a standard mastectomy, which involves removing all skin from the breast and nipple, a skin-sparing mastectomy leaves the skin and nipple intact. Once the underlying tissue has been removed, the doctor will quickly reconstruct the breast by placing an implant beneath the skin.
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Reconstruction After Total Mastectomy - Reconstruction choices vary if one requires a total mastectomy as opposed to a skin-sparing mastectomy. Certain individuals are eligible for immediate reconstruction, in which implants are inserted immediately following a mastectomy. Others must postpone reconstruction because they require a tissue expander to provide space for implants following the removal of their breast tissue and other surrounding tissue.
How Does Oncoplastic Surgery Function?
Oncoplastic surgery is carried out in combination with a lumpectomy. The tumor, a tiny portion of the surrounding tissue, and a few of the surrounding lymph nodes (whenever required) will all be removed by the surgeon first. To make the two breasts symmetrical, the plastic surgeon will next execute a bilateral breast reduction or lift. The procedures for plastic surgery and breast cancer surgery are carried out one after another.
What Are the Benefits of Oncoplastic Surgery?
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It needs only one surgical procedure, and hence, healing time is reduced.
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It makes it possible to remove more tissue, which is beneficial for larger tumors.
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Facilitates the development of symmetrical breasts.
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Oncoplastic surgery is carried out before radiation treatment, thus helping patients prevent any issues from radiation exposure to surgical wounds.
Conclusion
Reconstruction by immediate breast-conserving surgery (BCS) combines the knowledge of both plastic and cancer surgeons. It is seen to be promising, particularly when carried out before radiation therapy. However, there is little scientific data regarding the safety and aesthetics of oncoplastic procedures. There is little information regarding the effects on distant metastases, local recurrences, and overall survival. The effectiveness and safety of immediate BCS reconstruction, as well as its long-term consequences on patients with breast cancer, require more investigation. BCS reconstruction patients frequently report fewer problems, a decreased need for follow-up procedures, and better cosmetic outcomes. Patients with early-stage breast cancer who wish to have breast-conserving surgery may find that quick oncoplastic operations are a safe option; however, more research is needed to determine the long-term and cosmetic results.
