Reconstruction After Breast-Conserving Surgery
Breast-conserving surgery (also referred to as a Lumpectomy, or partial mastectomy) is when a part of the breast is removed to remove the tumour and not the whole breast. There are three ways of trying to maintain shape and replace the volume of the tissue lost from removing a tumour during a breast-conserving operation:
This involves moving some of the remaining breast tissue around to reshape the breast and fill out the area where the cancer has been removed. This surgical procedure is sometimes called a therapeutic mammoplasty (link to glossary of terms). If this technique is used, the patient is likely to need an operation to the other breast to reduce volume, restoring symmetry.
Replacing lost volume in the breast with tissue from elsewhere, usually from the patient's back (called a latissimus dorsi flap), is known as volume replacement.
This is less commonly used than volume displacement.
Patients may need radiotherapy after either of the procedures above.
This technique involves removing fat from one area of the body, processing it, then injecting it in tiny amounts to other areas of the body that need more volume. This is done in order to fill noticeable indentations in the breast, or to increase the size of the breast/adjust the shape after the reconstruction.
It is important to note that, while lipomodelling can be done under local or general anesthetic, additional treatments may be needed. Early results for lipomodelling as an adjunctive treatment post-reconstruction have been quite promising, though this does not mean that all women are suitable for reconstruction and/or lipomodelling.
In selection of patients for breast-conserving treatment with radiation, the health care professional must follow the indications/contraindictions of radiation therapy.
Lipomodelling can also be a useful tool to fine tune the results post-mastectomy with either implants or a patient's own tissue as well as in breast-conserving surgery.