Introduction to Oncoplastic Breast Conservation Surgery

Breast Conserving Surgery (BCS) has established itself as the standard of care for most of the early and selected locally advanced breast cancer patients. Poor cosmetic outcomes following BCS have been reported in up to 30% patients, leading to disturbed body image, sexual disturbances, and a reduction in quality of life. To overcome these issues the concept of oncoplastic breast conservation surgery was introduced. Oncoplastic Breast Conserving Surgery (OPBCS) combines the two goals of breast conservation, resection of tumors with negative margins and preserving an aesthetically appealing breast by reconstructing the resected area by one or more techniques of plastic surgery. Besides achieving a superior cosmetic result, OPBCS has also been reported to result in superior oncologic and quality of life outcomes, although there is no level I evidences to it. With the emergence of “breast surgery” as a distinct specialty, many of these procedures, once considered to be the domains of plastic surgeons are now being performed by breast surgeons. Some of these procedure can be performed after minimal training while some complex oncoplastic techniques require training in plastic surgery. The goal of this chapter is to make the general surgeons aware about the concept of oncoplasty, evidence for it, and various techniques available for use. The details of the surgical techniques are beyond the scope of this chapter and can be found from the cited literature.