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Reconstruction for Breast Cancer Patients Undergoing Lumpectomy

Breast cancer patients undergoing lumpectomy who choose to have reconstruction have the option of having everything done by two surgeons during one procedure. This procedure is oncoplastic reconstruction—a type of breast reconstruction that’s done in conjunction with a lumpectomy.

To find out more about oncoplastic reconstruction, we spoke with Andrew S. Newman, MD, a plastic surgeon at Abington – Jefferson Health.

Defining Oncoplastic Reconstruction

Oncoplastic reconstruction is a surgical technique that combines plastic surgery and oncologic surgery; it’s a type of reconstruction that happens specifically during a lumpectomy procedure.

“When an oncologic surgeon performs a lumpectomy, they’re removing a portion of the breast where the tumor is located. If the surgery is done by itself, the breast will have a defect created by the lumpectomy once it’s healed,” says Dr. Newman.

Instead of performing a separate procedure to fix defects in the breast caused by the lumpectomy, oncoplastic reconstruction involves two surgeons working in concert during the same surgery. “Once the oncologic surgeon removes the tumor and surrounding tissue from the breast, the plastic surgeon will rearrange the tissue to reshape the breast,” says Dr. Newman. “Then, the plastic surgeon will perform a reduction on the other breast to match the new size of the one from which the tumor was removed.”

Benefits of Reconstruction During Lumpectomy

The biggest benefit to breast cancer patients who have oncoplastic reconstruction is that they only have to experience one surgery, instead of going back for reconstruction later. “This is an appealing procedure for patients who want reconstruction but want as little surgery as possible,” says Dr. Newman. “And for those who were already interested in getting a breast reduction, this is a great option.”

According to Dr. Newman, there are, of course, still complications and risks with this surgery. But compared to a mastectomy with full breast reconstruction, oncoplastic reconstruction involves much less surgery and recovery. “Oncoplastic reconstruction is an outpatient procedure, so there’s no overnight stay, and most patients have minimal pain and recover enough to return to work within about four weeks,” he says.

Determining Your Eligibility

The healthcare team can help determine eligibility for oncoplastic reconstruction surgery, but here are general requirements for those who are interested:

  • Tumor is small relative to your breast size
  • The tumor is not multifocal—affecting two or more spots in your breast
  • The tumor is not close to the skin

In general, larger breasts or smaller tumors make oncoplastic surgery a more viable option for patients. “Most breast surgeons try to remove a larger section of tissue out when performing a lumpectomy in hopes of avoiding a positive margin. When a patient has larger breasts, we have more tissue to work with in terms of reconstruction,” says Dr. Newman.

Many breast cancer patients also choose chemotherapy as the first line of defense against cancer, as it could shrink the tumor before surgery. “It’s important to note that chemotherapy doesn’t prohibit oncoplastic reconstruction procedures, so if you have a tumor that may be too large, it’s possible that you could be eligible for surgery after chemo,” says Dr. Newman.

If you’re interested in oncoplastic reconstruction surgery, speak with your healthcare team to find out if it’s an option for you.

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