my frind said that breast restoration after cancer can be done without causing disfiguring results. she said it is called "breast conserving surgery". Can you explain this technique? Do only a selct few surgeons do it? Thank You!
Breast Conserving Surgery
Doctor Answers 10
Breast Conservation Surgery in breast reconstruction.
Thanks for your question. There are two basic ways to "conserve the breast" during breast reconstruction. If both your breast surgeon (the surgeon performing the mastectomy) and your plastic surgeon are willing they can perform a nipple sparing mastectomy. This is a mastectomy that removes breast tissue but, like the term suggests, leaves the nipple and areola. This surgery can be used in certain circumstances depending on the type of cancer and the patients specific anatomy. This can allow for a very normal appearing breast following breast reconstruction. The other type of breast conserving reconstruction is a skin sparing incision. This type of reconstruction again revolves around your breast surgeon and plastic surgeon working together to limit the scar used during the mastectomy procedure. When done properly, the scar can then be covered by the nipple and areola reconstruction so no scar is seen following the final surgery. Hope this helps.
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Breast conserving surgery
Breast conservation surgery is just what the phrase states...conserve breast tissue. This can be done for small tumors and is best in large breasts. Modifications of breast lift/reduction techniques can be used sometimes.
Breast Conserving Surgery not a form of breast restoration
Breast Conservation Surgery, also known as partial mastectomy or lumpectomy, is an excellent option to preserve the breast depending on the size of the tumor, status of lymph nodes, and clinical staging. However, this type of surgery is not considered restoration, but more preservation. This surgery typically involves a course of postoperative radiation. Therefore, it must involve an educated discussion with your breast surgeon in regard to the risks/benefits of breast conservation versus mastectomy.
Breast restoration is typically offered to mastectomy patients. Occasionally, it may be necessary after radiation to a large lumpectomy defect. WIth the acceptance of skin sparing and nipple sparing mastectomies as safe oncologic procedures in the appropriate candidates, plastic surgeons are now able to offer even better aesthetic results, minimizing the disfiguring results seen with traditional mastectomy.
All the best in your decision process.
Paul S. Gill, M.D.
GIll Plastic Surgery
Houston Double Board Certified Plastic Surgeon
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"My friend said that breast restoration after cancer can be done without causing disfiguring results. she said it is called "breast conserving surgery". Can you explain this technique? Do only a selct few surgeons do it?"
"Breast conserving surgery" refers to any of a number of procedures used to treat breast cancer that remove a portion of the breast but preserve (or conserve) the majority of the breast. The most frequently used breast-conserving procedure is lumpectomy. To yield the same degree of effectiveness as a mastectomy, breast-conserving procedures are almost always combined with post-operative radiation therapy. Breast conserving procedures are not appropriate for the treatment of every breast tumor and not every breast tumor that can be treated with a breast conserving procedure should be treated with a breast conserving procedure. This is because in some cases, breast-conserving surgery can significantly distort the appearance of the breast and compromise its appearance.
When a woman wishes to undergo a breast-conserving procedure such as lumpectomy and the procedure may distort the breast, or leave it out of proportion to the other side, oncoplastic procedures may help her to achieve a more cosmetically desirable outcome without compromising cancer care. Oncoplastic surgery combines innovative plastic surgery techniques with breast surgical oncology to maximize both the oncologic outcomes and cosmetic results of breast conserving surgery. A plastic surgeon can work together with a breast oncologic surgeon at the time of surgery, to help best preserve or restore the shape of the breast. In addition, the opposing breast can also be modified, for example with a breast reduction or breast lift, to improve symmetry. Most breast surgeons perform breast-conserving surgery, but very few plastic surgeons perform oncoplastic procedures on a regular basis.
Since the options are vast, consultation and examination are really the only ways to find out which options would be best for a given patient. Furthermore, whenever possible, I suggest that women with breast cancer or DCIS/LCIS work with a breast management team (this would include a breast surgeon, breast oncologist, plastic surgeon, and radiation oncologist). Since there are so many possibilities, a team approach can help assure that all aspects of a women's care are coordinated to help achieve the best possible outcome.
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Regarding: "Breast Conserving Surgery
my frind said that breast restoration after cancer can be done without causing disfiguring results. she said it is called "breast conserving surgery". Can you explain this technique? Do only a selct few surgeons do it? Thank You!"
Your friend is right. Partly. Breast Conserving Surgery is NOT one operation but a FAMILY of techniques that can be used to remove suspicious or cancerous breast tissue UNDER CERTAIN CIRCUMSTANCES.
Not all breast cancers need to be treated by complete removal of the breast and not all breast cancers can be treated by saving the breast. What is true is that with a higher awareness on the part of breast surgeons, with an increasing voice of women demanding a say in how their breasts are treated and with more involvement of Plastic surgeons in planning breast reconstruction BEFORE the breast cancer is removed (by whichever method) , we are seeing much nicer and attractive breasts AFTER cancer treatments.
As you can see, the answers are not simple. If YOU need such care, see several surgeons before you have your procedure.
Dr. Peter Aldea
The reason why not all surgeons have embraced the team effort of breast reconstruction is partially because of inertia (I have always done it "this way", why change a good thing? way of thinking on the part of breast surgeons, oncologists and radiotherapists), because of decreasing reimbursements (with surgeons being paid less each year for these procedures there is a disincentive for taking up more time coordinating their schedules with that of other surgeons and apparent lack of interest and education by women. (If more women spoke out and demanded and paid out of pocket for better results (rather than relying on insurance companies), better breast care would become common.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.