Oncoplastic breast conserving surgery
When is this procedure indicated?
Oncoplastic breast conserving surgery is indicated when a patient is diagnosed with breast cancer and the tumor can be safely excised by removing the breast partially. When a portion of the breast is excised the remaining glandular tissue needs to be remodelled in order to preserve an acceptable cosmetic result, this happens through an oncoplastic approach.
How is it performed?
Oncoplastic breast conserving surgery includes a wide range of surgical procedures that consist of two phases: one oncological phase that is a wide excision of the glandular tissue including breast cancer, and one reconstructive part that allows breast reshaping. According to the percentage of breast tissue removed the oncoplastic operation could be: a level I procedure when less than 20% of breast volume is excised, no skin excision and no mammoplasty will be performed but the only reshaping of local glandular flaps is sufficient to restore the breast; a level II procedure when 20-50% of the breast volume will be excised, so mammoplasty techniques will be applied, excess skin will be removed, nipple and areolla will be re-centralized and eventually, a contralateral breast reshaping will be also performed for achieving a better symmetry. One drain per breast could be placed.
The discharge occurs the same day of surgery after level I procedures, during the first or second postoperative day in case of level II procedure. Recovery after discharge depends upon the type of surgical procedure performed. It could varies from a few days after a simple level I procedure to two weeks after a complex level II procedure.
Intraoperative or postoperative bleeding, infection, dehiscence, need for re-intervention due to bleeding or positive margins, keloids, breast asymmetry, low satisfaction for cosmetic results, necrosis of the skin or of the nipple-areola complex, seroma eventually requiring needle aspiration, local pain.