Cancer in Singapore has been on the rise, with breast cancer being the most common cancer among women here. It accounted for 29.7% of total female cancer cases from 2016-2020, according to the Singapore Cancer Registry Annual Report 2020.
Most patients with breast cancer will require surgery to remove the cancer cells. The good news is that mastectomy is not the only surgical option.
Breast-conserving surgery such as oncoplastic breast surgery[1] enables patients to preserve their breasts, maintaining their quality of life, with proper removal of the cancer tissue for treatment. Oncoplastic breast surgery is also increasingly being used for large tumours[2]. Many clinical studies have shown that the overall and disease-free survival rates of oncoplastic breast surgery are equivalent to those of mastectomy[3].
How does oncoplastic surgery achieve the above goals? The first step is the removal of the breast cancer from the breast. Following this plastic surgery techniques are performed to either reshape the remaining breast tissue into a smaller but normal breast, or tissue from areas around the breast (below the breast or from the side of the breast) is used to fill the space created by the cancer removal. A trained oncoplastic breast surgeon can do all of that. Occasionally, for more complex cases, a plastic surgeon may be part of the surgical team.
Oncoplastic surgery with radiation equals mastectomy survival rates
According to a Swedish study of 48,986 Swedish women diagnosed with early-stage breast cancer and who had breast cancer surgery from 2008 to 2017, the five-year breast cancer-specific survival rates by surgery group were 98.2% for those who had a lumpectomy with radiation. The research was published online on May 2021 by the journal JAMA Surgery[4].
Improves patients’ quality of life and pleasure
Oncoplastic surgery, also offers several positives when compared to a mastectomy. As the surgical procedure combines cancer resection with plastic surgery techniques to reshape the breast for a final aesthetic outcome, it allows the woman to retain her breast. The retained breast can fit into the patient’s bra, enabling her to move and feel the reconstructed breast as part of her body.
Oncoplastic surgery, used to address both medical and aesthetic concerns has also been shown to significantly improve the long-term wellbeing of women. As it is a less radical form of surgery, surgical trauma and morbidity to breast cancer patients are minimised.
The results of a survey research published in the International Open Access Journal of the American Society of Plastic Surgeons[5] revealed that 89% of participants rated oncoplastic surgery as better than mastectomy. At the same time, the research also reported high outcome scores for breast appearance, physical and emotional wellbeing even after the procedure had been done for 15 years.
Oncoplastic surgery preserves the breast by correcting the lumpectomy defect
In oncoplastic surgery, the oncoplastic breast surgeon pays attention to the shape and appearance of the breast. Patients’ breasts will usually retain sensation as most of their natural breast tissue is preserved after the surgery.
As the breast specialist can also remove more tissue in oncoplastic surgery than with lumpectomy alone, this is more likely to result in cleaner margins[6]. In addition, for larger-breasted women who undergo a breast reduction as part of oncoplastic surgery, having less breast tissue may lower the risk of cancer recurrence and make future breast screenings easier[7].
Similar to a regular lumpectomy, the breast specialist performing oncoplastic surgery will send the removed tumour for pathology testing. The pathologist will make sure that the breast specialist achieves clean margins. Having a clean margins test[8] means that no cancer is present at the edges of the rim of healthy tissue, which was removed along with the tumour, by the surgeon.
Single surgery, single recovery period
With oncoplastic surgery, everything can be done in a single operation/procedure. This includes the removal of the breast cancer, with immediate partial reconstruction using the patient’s remaining breast tissue, or neighbouring tissue. Patients generally take about four to six weeks to recover and strenuous activities should be avoided during this period.
Are you interested to learn more about oncoplastic breast surgery? Our breast specialists at Solis Breast Care and Surgery Centre will guide you every step of the way. Schedule an appointment with us right away by clicking here.
[1] PubMed.gov, Oncoplastic breast surgery: comprehensive review
[2] PubMed.gov, Oncological advantages of oncoplastic breast-conserving surgery in treatment of early breast cancer
[3] National Library of Medicine, Recurrence and survival after standard versus oncoplastic breast-conserving surgery for breast cancer
[4]Breast Cancer.org, Lumpectomy Plus Radiation Offers Better Survival Rates Than Mastectomy for Early-Stage Breast Cancer
[5] National Library of Medicine, Patient-Reported Outcomes Are Better after Oncoplastic Breast Conservation than after Mastectomy and Autologous Reconstruction
[6] Breast Cancer.org, Reconstruction After Lumpectomy
[7] Breast Cancer.org, Reconstruction After Lumpectomy
[8] Breast Cancer.org, Reconstruction After Lumpectomy
Other References:
1) SingHealth Duke-NUS Breast Centre, SingHealth, Oncoplastic breast surgery
2) PubMed.gov, Oncoplastic breast surgery: comprehensive review
