Oncoplastics – Optimising Cancer Care & Cosmesis

The Problem

Traditionally breast conserving cancer surgery (also termed ‘wide local excision’ or ‘lumpectomy’) makes straight incisions directly over the tumour, regardless of the location in the breast, leaving an empty hole in the breast tissue. This causes a mismatch between the same area of breast skin envelope now covering a smaller amount of breast glandular tissue beneath. Although the short term results may seem acceptable as the cavity fills with fluid (seroma), this fluid will soon disappear and the wound contracts into the scar.  This is worsened by radiotherapy and often leads to irreversible deformities that are difficult to correct. This is true the greater the volume of tissue removed relative to the natural shape of the breast.

In other words, breast surgeons who remove significant amounts of breast tissue must be mindful of appropriately reshaping the breast and patients should ask their surgeons about this.

The Solution: Oncoplastic breast surgery

Oncoplastic breast surgery recognises the importance to a woman undergoing cancer surgery of long term breast cosmesis, especially in terms of shape and scars.  Oncoplastics applies plastic surgery techniques of breast reduction and breast lift as well as placing scars away from the cleavage area to reshape the breast for an optimal aesthetic result while at the same time completely and safely removing the tumour. This approach requires subspecialty training and involves a combination of skin resection and either breast volume displacement or replacement. The result is often a smaller volume yet shapely, more youthful breast and the opposite breast can later be symmetrised (lifted or made smaller or bigger to match the other breast) following the completion of cancer treatment, should the woman so desire.

Dr Chong has specialist training in oncoplastic surgery which sets him apart from many other Melbourne breast surgeons and he is pleased to offer these techniques to his patients.  After undergoing  oncoplastic breast surgery Dr Chong also offers his patients:

  • symmetrising surgery (making the other breast smaller and/or more lifted to match the operated side)
  • lipofilling (transferring fat from the thighs and belly into contour deformities from oncoplastic surgery)

Who is suitable for oncoplastics?

Most women with breast cancer can be considered for oncoplastic surgery including those with:

  • large tumours to be removed for whom significant deformity will result with conventional approaches
  • moderately large or saggy (ptotic) breasts wishing for breast reduction/lift at the same time as their cancer surgery
  • tumours in the cleavage “décolletage” area
  • small breasts for whom even small resections result in deformity significant
  • a wish to balance the opposite intact breast with the breast that has had previous cancer surgery (“symmetrisation“)