Oncoplastic Breast Surgery & Breast Reconstruction
Oncoplastic surgery applies the principles of plastic and cosmetic breast surgery to breast cancer surgery. Some of the many potential benefits of being able to offer this range of surgical skills are:
- Better cosmetic outcomes from breast cancer surgery - This ranges from creating a neat simple mastectomy scar, to minimising deformity after breast-conserving surgery, to breast reconstruction after mastectomy.
- More options - One of the big areas of benefit is the greatly increased range of options for breast-conserving surgery such that more women have the option of avoiding mastectomy.
- Better cancer-related outcomes - This has yet to be proven but oncoplastic surgery can potentially enhance the effectiveness of breast cancer surgery by enabling cancers to be excised with a wider clearance margin. In addition using oncoplastic techniques, it is more likely that the cancer is excised with a clear margin at the first attempt. In some cases the ability to achieve a large margin of excision may mean that radiotherapy is not required (e.g. breast-conserving surgery for DCIS).
- Better quality of life after breast cancer surgery - As treatment of breast cancer improves and life-expectancy after breast cancers increases, quality of life is a very important outcome. There are of course many factors that influence quality of life but from a breast surgery perspective this can sometimes be improved by oncoplastic surgery. For instance, the effects of cancer removal on appearance can be minimised using the principles outlined above. In addition, cancer surgery can also include adjustment of overall breast size or shape; large breasts can be made smaller; small breasts can sometimes be made bigger; and the aging breast can sometimes be given an uplift.
The principle of effective and uncompromising treatment of the breast cancer remains the primary aim for the oncoplastic breast surgeon just as it does for a breast surgeon who cannot offer these skills. The difference is that the oncoplastic surgeon has a wider range of techniques to use in different situations.
Expertise in breast cancer surgery and breast plastic surgery allows an oncoplastic surgeon to recommend surgical procedures with a full knowledge of the effect that they may have on the cancer outcome and vice versa (sometimes cancer treatments can affect the appearance after breast surgery).
No surgeon should work in isolation. Mr Macmillan leads a team of surgeons with a special interest in breast surgery and between them they are able to offer the full range of breast reconstruction procedures. In this regard, Mr Macmillan does not perform microsurgery, which is the technique required for breast reconstruction using the tummy (DIEP flap). Women who require this would be referred to one of Mr Macmillan's colleagues.
Mr Macmillan teaches regularly at local, national and international meetings on the techniques and practice of oncoplastic breast surgery and has performed many live surgery demonstrations.
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