Our Summary

This paper is about modern methods of breast cancer surgery that aim to both treat the disease and maintain a good quality of life and appearance for the patient afterwards. These methods are grouped under the term oncoplastic breast conserving surgery (OPS). The authors note that there is little standardization of these techniques and training is rare in many countries, which makes it difficult to scientifically evaluate them.

To address this, the authors propose a way to standardize the naming and use of these techniques. They suggest four categories of breast conserving surgery: conventional tumor removal, oncoplastic mastopexy, oncoplastic tumorectomy, and oncoplastic reduction mammoplasty. They also describe several techniques for reshaping the breast after tumor removal.

The authors also suggest a method for deciding which type of surgery to use based on the size and shape of the breast and the tumor. They also propose a method for choosing the best way to reconstruct the breast after surgery, based on where the tumor was and the blood supply to the breast.

The authors believe that these methods will make it easier to customize each surgery to the patient’s needs, as well as making it easier to study and improve these techniques. They also note that existing research suggests that these techniques have similar rates of cancer recurrence as traditional surgery, but with better cosmetic results and patient satisfaction.

FAQs

  1. What is oncoplastic breast conserving surgery (OPS)?
  2. What are the four categories of breast conserving surgery proposed by the authors?
  3. How do the authors suggest deciding which type of surgery to use and how to reconstruct the breast after surgery?

Doctor’s Tip

A helpful tip a doctor might tell a patient about lumpectomy is to follow post-operative care instructions carefully, including taking any prescribed medications, attending follow-up appointments, and avoiding strenuous activities that could disrupt the healing process. Additionally, it is important to communicate any concerns or changes in symptoms to your healthcare provider promptly. Lastly, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help support overall recovery and long-term health.

Suitable For

Patients who are typically recommended lumpectomy are those with early-stage breast cancer, where the tumor is small and localized. Lumpectomy is often recommended for patients who have small tumors in relation to the size of their breast, as well as for patients who wish to preserve as much of their breast as possible. It is also a good option for patients who are not candidates for or do not wish to undergo mastectomy.

Patients who have tumors that are easily accessible and can be removed with clear margins are good candidates for lumpectomy. Additionally, patients who have tumors that are not too close to the chest wall or other vital structures may also be recommended lumpectomy.

Overall, lumpectomy is a good option for patients with early-stage breast cancer who want to preserve their breast and maintain a good quality of life and appearance after surgery. It is important for patients to discuss their options with their healthcare provider to determine the best treatment plan for their individual situation.

Timeline

Timeline of what a patient experiences before and after lumpectomy:

Before lumpectomy:

  1. Patient is diagnosed with breast cancer through imaging tests and biopsies.
  2. Patient discusses treatment options with their healthcare team, including lumpectomy.
  3. Patient undergoes pre-operative tests and evaluations to ensure they are healthy enough for surgery.
  4. Patient may undergo neoadjuvant therapy (chemotherapy or radiation) before surgery to shrink the tumor.
  5. Patient meets with a plastic surgeon if reconstruction is desired after lumpectomy.

After lumpectomy:

  1. Patient undergoes the lumpectomy procedure, which involves removing the tumor and a small margin of surrounding tissue.
  2. Patient may have lymph nodes removed during the same surgery if necessary.
  3. Patient is monitored in the hospital for a short period of time before being discharged.
  4. Patient may experience pain, swelling, and bruising in the surgical area, which can be managed with pain medication.
  5. Patient is advised to avoid strenuous activities and heavy lifting for a period of time to allow for proper healing.
  6. Patient may undergo adjuvant therapy (chemotherapy, radiation, hormone therapy) after surgery to reduce the risk of cancer recurrence.
  7. Patient follows up with their healthcare team regularly for monitoring and follow-up care.
  8. Patient may undergo breast reconstruction surgery if desired after completing cancer treatment.

What to Ask Your Doctor

  1. What are the potential risks and complications associated with a lumpectomy?

  2. How will the lumpectomy affect the appearance of my breast?

  3. Will I need additional treatments, such as radiation therapy, after the lumpectomy?

  4. What is the likelihood of the cancer recurring after a lumpectomy?

  5. How long is the recovery period after a lumpectomy?

  6. Will I need any follow-up procedures or tests after the lumpectomy?

  7. Are there alternative treatment options to a lumpectomy that I should consider?

  8. How experienced are you in performing oncoplastic breast conserving surgery techniques?

  9. Can you explain the specific technique you plan to use for my lumpectomy and how it will impact the appearance of my breast?

  10. Are there any clinical trials or research studies that I may be eligible for related to lumpectomy procedures?

Reference

Authors: Weber WP, Soysal SD, Fulco I, Barandun M, Babst D, Kalbermatten D, Schaefer DJ, Oertli D, Kappos EA, Haug M. Journal: Eur J Surg Oncol. 2017 Jul;43(7):1236-1243. doi: 10.1016/j.ejso.2017.01.006. Epub 2017 Jan 31. PMID: 28214053