Innovations In Breast Cancer Surgery: Oncoplasty, Hidden-Scar, and Skin-Sparing Procedures

Patient Expert

"It's the next frontier in breast cancer surgery," says Dr. David Byrd of the Seattle Cancer Care Alliance.

Whoa That's quite a statement. Back in the day, a woman's only choice to remove her tumor was a brutal radical mastectomy, surgery that not only removed the tumor but the woman's entire breast and surrounding chest muscles, leaving her disfigured and often incapacitated. Since then, not only have mastectomies become less invasive, but breast-conservation surgery (lumpectomy) has stepped in as a viable alternative for many women.

So for women needing breast cancer surgery, what's the next frontier? Oncoplasty, that's what.

About  Oncoplasty

For the past several years, this combination of general surgery and plastic surgery has slowly been growing here in the U.S. And that's good news for the increasing number of women scheduled for breast-conservation surgery (lumpectomy).

So what exactly is oncoplasty? It's a type of surgery that removes a woman's breast tumor plus enough of the surrounding tissue to clean up any errant cancer cells; and at the same time, fills the gap by reshaping the tissue around it. The result? A "whole" breast, one without an empty cavity.

Bottom line with oncoplasty? Healthwise, the radiation that customarily follows a lumpectomy can be focused on a much smaller area, leading to fewer complications. And future mammograms will be more effective, as they won't be "fooled" by distortions in the breast resulting from missing tissue.

Cosmetic results of oncoplasty? No more divots! For those of you who've had a lumpectomy or major biopsies, you know this is an issue. The goal of oncoplasty is to leave your breast looking as smooth, natural-looking, and as identical to the opposite breast as possible.

About Hidden-Scar Surgery

Along with reshaping the breast at the time of surgery, another innovation coming down the pike is "hidden-scar surgery," in which the incision to remove the tumor is made right underneath a woman's breast, rather than at the nearest point to the tumor, as has been done in the past. In most women, the surgical scar is then hidden by the natural contours of her breast.

Lumpectomy without a lumpy breast, and no visible scarring? That's sweet.

About Skin-Sparing Mastectomy

And breast-conservation surgery isn't the only breast surgery getting a facelift. The skin-sparing mastectomy, in which a woman's breast tissue is removed but the skin left intact, has been available for 10 years or more. But now women facing removal of their entire breast may be able to have surgery that spares not only their skin, but their nipple as well.

For many women, mastectomy with reconstruction has resulted in a breast that looks pretty good in clothes, but not so good on close examination. Rebuilding a nipple is chancy at best; the new nipple only vaguely resembles a natural nipple, and tattooing is required to "draw in" the areola. Now, surgeons are able to take out all of the breast tissue, and leave all of the "outer shell" skin and nipple both. The "shell" is then filled with tissue from another part of the body.

The result: A breast that comes a lot, lot closer to resembling the original, clothed or not.

Sure, the main objective of breast cancer surgery is to remove the tumor. But, as most women will tell you, taking the tumor while leaving a natural-looking breast is huge for emotional recovery. So if you're facing a lumpectomy or mastectomy, ask about these new surgical developments; although they're still "cutting edge," they just might be available at a hospital or cancer center near you.