Breast Onco-Plastic Surgery: The Saving Grace

Breast cancer is the most common cancer among women. Earlier complete removal of the breast or mastectomy was the most common surgical option for breast cancer patients. However, with the advent of better chemotherapy and radiotherapy options breast can be saved now in good number of patients, by the procedure known as breast conserving surgery (BCS). The success of breast conservation surgery (BCS) is based on complete removal of cancer with adequate surgical margins with preservation of natural shape and appearance of the breast. Breast oncoplastic surgery (OPS) is the new approach for breast conserving surgery to avoid mastectomy without compromising oncological principles, while saving the breast with good cosmetic outcome. Oncoplastic surgery is the combination of both onco-surgery and plastic surgery. Breast conservation surgery with adjuvant radiotherapy is preferred locoregional treatment for majority of patients with early breast cancer, even for locally advanced breast cancer after neoadjuvant (preoperative) chemotherapy. In oncoplastic breast surgery survival is almost same as mastectomy while giving better cosmetic outcomes in term of shape, size and appearance of the breast. In breast oncoplastic surgery cosmetic outcome depends on the volume of breast and ratio of tumour size to breast size. On the basis of resection of breast volume, it is classified mainly as two types. Level 1 OPS is for resection less than 20% of the breast volume. Level 2 OPS is for larger resection (20-50%) of breast volume, which require mammoplasty techniques also. In this technique only remaining breast tissue after resection is reshaped and repositioned without taking tissue from other part of the body. Breast conserving surgery along with oncoplastic surgery gives good cosmetic and psychological benefits to breast cancer patients without compromising the overall survival outcome.

Dr. Niranjan Naik 
Director Surgical Oncology

Dr. Sushil Kumar Jain 
Senior Consultant Surgical Oncology