Oncoplastic Surgery for Breast Cancer Treatment

Oncoplastic surgery for breast cancer is an advanced treatment approach that combines tumor removal with plastic surgery techniques. The goal is to effectively treat the cancer while preserving or restoring the natural appearance of the breast. Immediately after a breast surgical oncologist removes the tumor and a slim margin of surrounding healthy tissue, a plastic surgeon will reshape the remaining breast tissue to achieve a more aesthetically balanced result. By combining cancer treatment with cosmetic refinement in a single surgical session, oncoplastic surgery may reduce the need for further reconstructive procedures.

What are the types of oncoplastic surgery for breast cancer treatment?

There are two main types of oncoplastic surgery for breast cancer:

• Volume displacement – The plastic surgeon will reshape the patient’s existing breast tissue, sometimes incorporating a breast reduction or lift, to create a more natural, symmetrical appearance.
• Volume replacement – If a significant amount of breast tissue must be removed to treat the cancer, the plastic surgeon may use tissue from another area of the body, such as the back or abdomen, to help restore the breast’s natural contour.

Who is a good candidate for oncoplastic surgery for breast cancer treatment?

Oncoplastic surgery is not appropriate for every breast cancer patient. Candidacy is determined on an individual basis following a thorough evaluation by a multispecialty care team. In general, this approach may be considered for a patient who is eligible for breast-conserving surgery (lumpectomy) and wishes to preserve or enhance the cosmetic appearance of the breast after tumor removal.

Several factors will be taken into account when evaluating a patient for oncoplastic surgery, including:

• Tumor stage – Oncoplastic techniques are most frequently used in cases of stage 1 or stage 2 breast cancer, where the tumor is relatively small and confined to one area of the breast.
• Tumor size and location relative to breast volume – Oncoplastic surgery may be especially beneficial for a patient with a tumor located in a cosmetically sensitive area. A woman with relatively large breasts may be a good candidate for volume displacement, especially if she is open to breast reduction.
• Preference for breast conservation – A patient who wishes to avoid mastectomy (if possible) and preserve the natural appearance of her breast may be well suited for oncoplastic surgery.
• Overall health status – Because oncoplastic surgery may involve a longer operative session and recovery period compared to standard lumpectomy, the patient should be healthy enough to safely undergo the procedure.
• Eligibility for radiation therapy – Because breast-conserving surgery is usually followed by radiation treatment, the patient should not have contraindications.
• Nonsmoking status or willingness to quit – Tobacco use can increase the risk of surgical complications and impair wound healing. Nonsmokers and those who are committed to quitting before surgery tend to experience better outcomes.

What are the potential benefits of oncoplastic surgery for breast cancer treatment?

In the right clinical scenario, oncoplastic surgery can offer several important advantages for a patient undergoing breast-conserving cancer treatment. In addition to an improved cosmetic outcome, potential benefits may include:

• Expanded surgical options – Oncoplastic techniques can make it possible to remove a relatively large tumor or a tumor that is located in a cosmetically sensitive area while still preserving the breast. This can broaden the eligibility for breast-conserving surgery and may allow some patients to avoid mastectomy if they wish.
• Oncologic safety – Oncoplastic surgery adheres to the same rigorous standards as traditional cancer surgery. The surgical team can achieve a wide tumor-free margin while also minimizing any cosmetic defects, ensuring that cancer control is not compromised.
• Reduced need for additional surgery – Because the cancer treatment and plastic surgery are performed during the same surgical session, the patient may avoid the need for staged or delayed breast reconstruction, minimizing the physical and emotional burdens of multiple procedures.
• Enhanced quality of life – Preserving the breast’s appearance can contribute to a more positive body image, greater psychological well-being and an overall improved quality of life after cancer treatment. Many patients report high levels of satisfaction with the aesthetic and functional outcomes of oncoplastic surgery.

Breast Cancer Outcomes

The goal of any cancer treatment is to achieve the most favorable outcome while minimizing side effects and ensuring the best possible quality of life. On average, Moffitt's breast cancer treatment survival rates exceed 1.5 times the national average.

Our Outcomes

How to prepare for oncoplastic surgery for breast cancer treatment

Preparing for oncoplastic surgery involves several important steps to ensure the procedure goes as smoothly as possible. These include:

• Medical evaluation – The patient will undergo an in-depth clinical assessment, including a physical examination, imaging tests and lab work. To plan the procedure, the surgical team will thoroughly assess multiple factors, including the cancer diagnosis and the type, stage, location and size of the tumor.
• Consultations with a multidisciplinary team – Preparation for oncoplastic surgery will include meetings with the breast surgical oncologist and plastic surgeon, who will fully explain the surgical plan, potential risks and expected results. The patient may also meet with other specialists, such as a radiation oncologist or medical oncologist, to coordinate any additional treatments that may be needed before or after surgery.
• Medication review – When meeting with the surgical team, the patient should provide a list of their current medications, including prescription drugs, over-the-counter remedies, vitamins and supplements. Certain medications, such as blood thinners and nonsteroidal anti-inflammatory drugs (NSAIDs), may need to be adjusted or paused before surgery to reduce the risk of bleeding.
• Lifestyle adjustments – To support healing and reduce the risk of complications, the patient will be encouraged to maintain a nutritious diet and remain physically active (as tolerated), both before and after the procedure. If the patient smokes, they should stop using tobacco well in advance of surgery.
• Preoperative planning – The patient will receive detailed instructions about fasting before the procedure, when to arrive at the surgery center and what to bring. It will be important to arrange for transportation and support at home during the initial recovery period.

What to expect after oncoplastic surgery for breast cancer treatment

After oncoplastic surgery, the patient can expect a period of recovery that includes both physical healing and follow-up care. Initially, there may be some temporary swelling, bruising and discomfort at the treatment site, which can usually be managed with prescribed pain relievers. To help prevent fluid buildup, a surgical drain may be placed after surgery; if so, it will be removed during a postoperative visit, usually within a few days.

Most patients return home the same day or after a brief hospital stay, depending on the extent of the surgery. Check-ups will be scheduled to monitor healing, remove stitches (if necessary) and discuss pathology results. The recovery time can vary, but many patients resume their normal routine within a few weeks, avoiding strenuous activities until cleared by their surgeon. If further treatment, such as radiation therapy or chemotherapy, is needed, the healthcare team will coordinate the next steps.

What are the risks and potential complications of oncoplastic surgery for breast cancer treatment?

As with any surgical procedure, oncoplastic surgery for breast cancer carries general surgical risks, including:

• Bleeding
• Infection
• Adverse reactions to anesthesia
• Delayed wound healing

Additionally, despite efforts to preserve or enhance the appearance of the breast, some patients may experience:

• Breast asymmetry
• Changes in nipple position or sensation
• Scarring or contour irregularities

In some cases, revision surgery may be needed to improve the aesthetic result or maintain breast symmetry, especially if only one breast is treated.

Additionally, because oncoplastic surgery is more complex than standard lumpectomy, any complications could delay the start of radiation therapy. However, this is uncommon with proper planning and postoperative care.

A patient who is considering oncoplastic surgery should discuss these risks with their surgical team to weigh the benefits and determine whether this approach aligns with their treatment goals and overall health profile.

How do the long-term results of oncoplastic surgery compare to standard lumpectomy?

Compared to standard lumpectomy, oncoplastic surgery generally offers a superior long-term cosmetic outcome while maintaining the same level of oncologic safety. Studies show that both procedures are equally effective in achieving local breast cancer control when clear margins are obtained. However, the advanced reconstructive techniques used in oncoplastic surgery can lead to a more favorable aesthetic result.

Unlike traditional breast-conserving surgery, which may leave visible indentations, breast asymmetry or contour irregularities (especially when a large volume of breast tissue is removed), oncoplastic surgery is designed to reshape the breast immediately after tumor excision. This approach allows the plastic surgeon to preserve or enhance the breast’s natural appearance and achieve better symmetry, often improving patient satisfaction and quality of life.

Additionally, oncoplastic techniques can allow for more extensive tissue removal when necessary, reducing the risk of positive margins and the need for re-excision, without compromising the visual outcome. As a result, oncoplastic surgery is increasingly regarded as the preferred approach for eligible patients seeking breast-conserving treatment.

Benefit from world-class care at Moffitt Cancer Center

In Moffitt’s high-volume Don & Erika Wallace Comprehensive Breast Program, oncoplastic surgery is a key element of breast cancer treatment. This approach is carried out by a collaborative team of experienced breast surgical oncologists and plastic surgeons who work together to integrate advanced aesthetic techniques into breast-conserving surgery. By combining oncologic precision with reconstructive expertise, we are expanding the surgical options available to our patients while improving both the medical outcome and the visual appearance of the breast.

If you would like to learn more about oncoplastic surgery, you are welcome to talk with a breast cancer specialist in Moffitt’s Oncoplastic Surgery Program, the largest program of its kind in the nation. To request an appointment, call 1-888-663-3488 or submit a new patient registration form online. We do not require referrals.