Oncoplastic Breast Surgery

By:Giles Bre
The Breast Clinic

The management of breast cancer has changed substantially over the past twenty years.

Improved screening techniques, better adjuvant therapy options, and refined surgical practices have led to a huge fall in mortality and improved survival from breast cancer by a huge rate, which is actually very good news. This trend is likely to continue as these modalities of treatment are continually improved to give better results and better care. The beginning of a multidisciplinary approach to patient care, earlier diagnosis, improved survival, quality of life issues and a more holistic approach has resulted in tailored and individualized surgical planning to give better results and allow a better healing of breast cancers. The fact that patient and doctor expectations raised has actually resulted in a need to optimise cosmesis and minimise psychological morbidity whilst maintaining safe removal of the cancer.

Traditionally the breast cancer surgeon would actually resect the breast cancer, and subsequent restorative surgery would be completed immediately or at a later date by a plastic surgeon that would have no connection with the surgeon who did the work on the cancer. Patients who underwent mastectomy were often not offered immediate reconstruction and this unfortunately remains the case in some private or public centres in the United Kingdom today. Worldwide, the traditional model of a general surgeon with an interest in breast disease is changing where cross-specialty skills acquired from breast oncology and plastic surgery are leading to the emergence of the "oncoplastic breast surgeon" trained in new techniques such as sentinel node biopsy and skin-sparing mastectomy that could help patient even more. The result of that is seamless specialist breast cancer surgery in which ablation of the cancer is merged with reconstruction. These require careful planning and a balancing of oncological need with aesthetic aim. Any patient with a breast lump should be subjected to rapid "triple assessment".

This triple assessment involves a detailed history and physical examination, imaging of the breast using mammography, ultrasound and MRI scanning if required, and biopsy of any specific area of concern. Any breast clinic offering oncoplastic breast surgery usually also offer a rapid triple assessment of all symptomatic breast patients in a convenient and comfortable environment.

So whether you go for a private breast cancer surgeon or a public one, do no wait if you think you have a breast cancer. Remember that breast cancer is actually the second most common type of cancer right after the lung cancer.