Oncoplastic Surgery: Combining Cosmetic And Curative Breast Cancer Procedures

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Although the vast majority of breast-cancer sufferers are primarily concerned with survival, many worry about the appearance of their breasts after a lumpectomy. The medical community’s response to this concern has been the emergence of a field known as oncoplastic surgery, which combines tumor removal with cosmetic repair.

“There is a growing awareness that we haven’t done as good a job as we should,” Nashville Breast Center director Pat Whitworth told the Wall Street Journal last year, regarding insufficient cosmetic care for those who undergo lumpectomies. Tumor removal during a standard lumpectomy can often leave a dent, which, depending on the patient’s options and preferences, may or may not be cosmetically corrected by a reconstructive plastic surgeon during a subsequent operation. With an oncoplastic approach, however, cancerous tissue is removed and healthy tissue is repositioned in a single shape-preserving, scar-hiding procedure, such as with the batwing mastoplexy techinque.

Despite the advantages of this increasingly popular discipline, oncoplastic surgery has given rise to apprehensiveness among some traditional oncologists. Last month, Monica Morrow, chief of Breast Service at Memorial Sloan-Kettering Cancer Center, wrote a web editorial for the British Medical Journal expressing concern that cosmetic goals were starting to threaten the effectiveness of lumpectomies.

“We must ensure that surgical approaches designed to improve cosmetic outcomes do not increase local failure and the risk of subsequent death from breast cancer,” she wrote. “The local treatment of breast cancer is based on the results of numerous high-quality clinical trials and is therefore a model for evidence-based care. As we attempt to advance from good to great cosmetic outcomes, it is important that we remember this.”

She recommends that oncoplastic surgical outcomes undergo numerous, diligent evaluations to ensure that survival is not being being sacrificed for aesthetics.

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