Breast Conserving Surgery

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Breast conservation surgery, is based on the principle of complete removal of the cancer with adequate surgical margins, whilst preserving the shape and appearance of the breast. This has stimulated the growth and advancement of oncoplastic surgery, which is based upon the integration of plastic surgery techniques for immediate breast reshaping of an oncological excision. This may be achieved by local flap reconstruction, breast prosthesis or autologous pedicled or free tissue transfer.

Wide local excision or Lumpectomy can be performed in patients with a relatively small tumour relative to breast size.

Benign tumours can be removed with dissection close to the tumour, as opposed to malignant tumours which require an adequate margin of normal, uninvolved tissue.

Tumours that are not easily palpable will require localisation technique prior to the surgery.  Most commonly, a fine wire with a small hook on the end is inserted into the middle of the tumour under either ultrasound or mammogram guidance, just prior to the procedure. This is called HOOKWIRE LOCALISATION.

Wide local excision or Lumpectomy can be performed in patients with a relatively small tumour relative to breast size.

Benign tumours can be removed with dissection close to the tumour, as opposed to malignant tumours which require an adequate margin of normal, uninvolved tissue.

Tumours that are not easily palpable will require localisation technique prior to the surgery.  Most commonly, a fine wire with a small hook on the end is inserted into the middle of the tumour under either ultrasound or mammogram guidance, just prior to the procedure. This is called HOOKWIRE LOCALISATION.

Other localisation techniques use carbon or radioisotope localisation.  The use of intraoperative ultrasound is now becoming  an evolving technique in order to find an impalpable tumour with precision and very little destruction to surrounding tissue.

Decision on the oncoplastic procedure to remove a breast lump must take into account the appearance of scar adherence and retraction post radiotherapy!

Breast cancers tend to be more common in the upper outer quadrant of the breast.

Incisions in breast tissue must take into consideration, the extent of the tumour and as to whether it involves skin; trying to prevent incision in the upper inner (decolletage) area which scars poorly, if oncologically safe; making use of areas which mask the scar including the periareolar (around the areolar margin) and inframammary fold (lowest breast crease).

In larger breasts, cancers which require a significant large volume excised, the local flap repair can be achieved by using a breast reduction technique.  This not only leaves a smaller and well shaped breast with a lift, but also removes the psychological downside of the diagnosis of cancer.

Procedure

Preferably performed under General Anaestheisa.

Time in Hospital:

Ranges from a day case to overnight stay.
Breast reduction technique may stay in hospital up to 3-5 days.

Incision:

• Over the cancer if it potentially involves skin
• Hidden: Periaerolar (arealor margin)
• Inframammary fold (in the breast crease where it meets the upper abdomen)
• Inverted T

Time in surgery:

Ranges from 30 mins to 2 hours.

Generally no drains required.

Potential Complications

Bleeding

Wound infection

Seroma (fluid collection)

Post Operative Care

No driving or heavy lifting for 2 weeks.

Wear support bra for comfort.

Potential Short Term Complications
(apart from General Anaesthetic risks)

Bleeding

Wound Infection

Margins of specimen involve tumour

What’s the next step?

The next step is to book a consultation with our qualified team.

You can book your treatment online or call our friendly team on 03 9041 8445.