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Oncoplastic Breast Reconstruction

A lumpectomy (with radiation) can be an excellent alternative to a mastectomy, and does not adversely affect overall survival rates. However, many women diagnosed with breast cancer find themselves being advised that a lumpectomy is not a viable option, “because removing the tumor will end up deforming the breast.”

This is true in many cases – if you simply remove a large part of a breast and don’t do anything to reshape the breast afterwards, of course the breast will heal with a large indentation. But this can be avoided if the breast is immediately reshaped to accommodate for the loss of tissue due to a lumpectomy. This reshaping has a name: it is called oncoplastic surgery.

Many women believe that the tradeoff for treating their breast cancer is a permanently scarred, indented, or damaged-looking breast. But in many cases, you simply do not need to make this tradeoff if you choose oncoplastic breast reconstruction. I am a specialist in this procedure, which saves more breast tissue for a better cosmetic outcome while thoroughly and completely removing cancerous tissue.

You have an alternative to traditional lumpectomy without any reconstruction or regard for final breast appearance. I have been performing oncoplastic breast reconstruction with a team of cancer specialists at Hoag Hospital in Newport Beach for many years, and have helped my patients achieve outstanding results.

If you have been diagnosed with breast cancer and a doctor has recommended a lumpectomy, oncoplastic breast reconstruction may be able to offer you a better outcome. contact us online or call 949-759-0980 for more information about this treatment and to learn why you should travel to Southern California for expert breast cancer care from an oncoplastic breast surgeon.

The Benefits of Oncoplastic Breast Reconstruction

Here is a brief outline of the benefits you can expect when you choose the cancer care team at Hoag Hospital for oncoplastic breast reconstruction. Read on below for more detail on the specific ways in which oncoplastic breast conservation achieves excellent outcomes for many patients.

Oncoplastic breast surgery:

  • Allows wider excision around the tumor for decreased risk of cancer recurrence, without compromising aesthetics
  • Creates a more satisfying cosmetic result over traditional reconstructive techniques, in many cases resulting in a breast shape that is better than what you started with
  • Requires only a single operation for cancer removal and reconstruction of the breast
  • Can be combined, in many cases, with single dose radiation treatment given immediately, in the operating room at the same time as the lumpectomy, making six weeks of follow-up radiation appointments unnecessary
  • Can be performed for patients with both noninvasive (DCIS) and invasive breast cancer
  • Is covered by major insurance plans and my office can assist with the necessary paperwork

What Is “Oncoplastic Reconstruction”?

As the name suggests (“onco” for oncology, the branch of medicine that deals with cancer, and “plastic” for plastic surgery), oncoplastic breast reconstruction combines treatment of cancer with a plastic surgery technique to immediately reshape the remaining breast tissue and achieve a more satisfying breast appearance following lumpectomy surgery. Oncoplastic breast conservation represents an entirely new philosophy in breast reconstruction that places increased importance on how a woman feels about the appearance of her breasts after surgery. It requires a coordinated approach with a team of medical professionals including a plastic surgeon, surgical oncologist, medical oncologist, radiation oncologist, radiologist, and pathologist.

In my experience performing this procedure, oncoplastic breast reconstruction techniques will allow a woman to have breasts that look as good, or even better, than they did before surgery. In every case, the surgery is designed to remove cancer cells as completely, and sometimes more completely, as any other breast cancer surgery technique.

savalia
Why Choose Dr. Savalia

It’s worth traveling for better breast cancer care. Dr. Savalia is a nationally recognized speaker on oncoplastic techniques and he can help you achieve a more satisfying result.

A Single Surgical Procedure

Oncoplastic breast conservation combines cancer surgery and breast reconstruction into a single-stage procedure. In my experience, most women facing a breast cancer diagnosis would prefer, when possible, to have reconstruction performed at the same time as their cancer surgery. A single-stage procedure helps in the psychological and emotional recovery of the women I treat. In addition, this eliminates the risks of performing multiple surgeries and allows my patients to move on with their lives sooner.

Real-Time Radiation Therapy

Oncoplastic breast conservation can be combined with intraoperative radiation therapy (IORT) for select low-risk patients. Our team has successfully treated well over 100 patients with invasive and noninvasive breast tumors 30 mm or less in total size. What this means is that real-time radiation therapy can replace the need for follow-up radiation treatments after surgery. Women are able to begin the healing process after surgery without the hassle and inconvenience of post-surgical radiation appointments. I can tell you more about whether you are a candidate for IORT after reviewing your case in detail with our breast cancer surgeons.

Insurance Coverage

Oncoplastic breast conservation procedures are covered just like other more traditional breast reconstruction techniques. My office can help you with the authorizations you will need prior to surgery to maximize your insurance coverage for the procedure.

Team-of-SurgeonsMeet Your Team of Surgeons

Dr. Savalia is part of the team at Hoag Hospital’s Breast Center that specializes in oncoplastic breast conservation. Learn more about this nationally recongnized program providing comprehensive care.More about the team

About the Other Breast

In most cases, oncoplastic surgery will be needed in only one breast. Almost always, I will perform a breast lift and/or breast reduction on the breast not affected by cancer in order to create symmetry and balance out the loss of volume from removal of the cancer. This can occur during the oncoplastic procedure or may be delayed to a second operation in some cases. Most of my patients prefer having a single surgical procedure for both breasts, but during your consultation we can discuss why you may want to wait.

What to Expect

Preoperative Planning

The planning that goes into your surgery will involve our full cancer care team. The following tests and information will need to be compiled during the evaluation and planning process:

  • Digital Mammography
  • Breast Ultrasound (Preferably of Both Breasts)
  • Axillary Ultrasound and Biopsy of Any Suspect Nodes
  • Breast MRI (Possibly)
  • Size and Extent of the Lesion Compared to the Size of the Breast
  • Family History and Genetic Counseling if Necessary
  • Your Own Cosmetic Goals and Expected Outcome

Day of Surgery

As a first step in your surgery, your radiologist will complete wire localization and nuclear sentinel node mapping to locate tissue abnormalities. This occurs either on the day of surgery or the afternoon before (for surgeries occurring very early the next day). Right before surgery, surgical areas will be marked, your procedure will be reviewed with you one more time, and you will have an opportunity to ask any questions.

The procedure takes place in an accredited OR that is stocked with the latest advanced medical equipment to ensure your safety. Depending on several factors, we will generally use one of three surgical techniques:

  • “Breast Lift” Technique: For tumors in small to medium sized breasts that have mild to moderate breast sagging, a Benelli or “donut” lift technique delivers excellent results. With this technique, we remove tissue containing the tumor along with a doughnut of skin around the nipple. The remaining tissue is reshaped to create a rounder and lifted breast with only one, well-hidden incision around the areola.
  • “Breast Reduction” Technique: This technique allows access to tumors anywhere in the breast. This approach is ideal for women with larger breasts where a considerable amount of tissue removal and rearrangement is required. Large amounts of breast tissue can be removed with excellent cosmetic results and generally widely clear margins.
  • “Split” Reduction Technique:  This advanced technique, developed by Dr. Savalia, is a modification of a breast reduction.  It allows removal of a tumor in any location of the breast, regardless of how close it is to the skin, with widely clear margins, and maintenance of an ideal breast shape.

If I will be performing plastic surgery on both breasts, we use a two-team approach to minimize total operating time. The cancer surgeon focuses first on the diseased breast while I work on the other breast, and then I will complete the reconstructive surgery on the diseased breast when the tumor has been removed. In most cases, women do not need drains for any oncoplastic breast conservation procedure.

Recovery

After your procedure is complete, your breasts will be wrapped in a compressive dressing that should be worn for 24 to 48 hours to minimize swelling and other complications. Our staff will be in frequent contact with you to make sure that you are comfortable and recovery is going smoothly. Sutures can be removed after about a week, with reduced swelling each week and scars from the incisions beginning to fade with proper care.

More Information

I am happy to provide more information on oncoplastic breast surgery and help you determine if it may be a good choice for your reconstruction. Please contact us online or call 949-759-0980 for more information.