Aesthetic outcome following lumpectomy
The diagnosis of breast cancer certainly is a traumatic experience, and the management of the disease is just as daunting a decision that must be made, often expeditiously. A lumpectomy, usually followed by radiation therapy, is a treatment modality that has been shown to be safe and effective. Your general surgeon will speak to you about the risks and benefits of this type of treatment for your breast cancer. Women who choose to save their breast by a lumpectomy, with the thought of avoiding any additional reconstructive surgery in the future.
The aesthetic outcome following lumpectomy has been researched heavily. Several reports show that approximately 1/3 of all patients who underwent breast-conserving therapy for their cancer are unhappy with their aesthetic result. 28% of these breast cancer patients were dissatisfied with their overall result. Of those polled, 46% felt that their physical appearance was worse, or much worse, following lumpectomy, and were now considering reconstructive surgery. Only 9% of these patients were ultimately satisfied with their outcome, however, would consider reconstruction if it were offered. Conservation is believed to be an acceptable way of saving a woman’s breast. But many of these women are coming to plastic surgeons for help, saying it isn’t so.
An interesting finding was that 26% of these patients were unhappy with their physical appearance after their BCT, but had an improved sense of body image. One thought is that patients are ultimately relieved of treating her cancer above anything else. The oncologic management should precede anything else in importance. There are manners in which to reconstruct partial breast defects following lumpectomy, but especially the radiation changes, which cause much of the breast distortion following lumpectomy. Earlier posts comment on radiation effects to the breast – such treatment often prohibits certain implant-based reconstruction in the future. Overall, many oncoplastic resections may be employed during the lumpectomy, which not only treats the cancer, but brings forth the best aesthetic outcomes following BCT. Otherwise, your plastic surgeons may discuss several treatment options for partial breast defects, which have been shown to obtain excellent results.
There are several means to ameliorate lumpectomy defect. One excellent method, which will be discussed in a later post involves coordinating a procedure in which the breast is reduced/lifted at the same time as the lumpectomy. By performing this at the same time, excellent results can be achieved with even wider margins than a lumpectomy alone, decreasing the recurrence rate overall. Within the tissue removed will include the cancer. Other modalities include fat grafting and local flap reconstruction for larger deformities; both of these will be discussed later as well. There are many options available for reconstruction of lumpectomy defects – call for a consultation to discuss all of the options.