Oncoplastic Breast Reduction

Who Is a Good Candidate?

Good candidates for oncoplastic breast reduction include women who have larger breasts who also desire breast reduction (as they may suffer from back and neck pain) or perhaps just droopy breasts who desire a breast lift.  Oncoplastic breast reduction allows these patients to reduce or reshape their breasts before radiation therapy. This is important as reduction or mastopexy surgery after radiation is difficult and prone to complications. Oncoplastic breast reduction is a breast conserving technique allowing women to preserve and often improve their breast and avoid mastectomy. This surgery is also useful in patients who have large tumors in relation to their breast size or in tumors in difficult locations within the breast (central, lower, and upper inner quadrants) that would result in significant breast deformity if standard breast surgery was performed. Breast cancer surgery with simultaneous breast reduction or lift reduces the risk of having a breast deformity and increases the likelihood of completely removing the tumor with clear margins on the first attempt and thus reducing the need for additional surgeries. Oncoplastic breast reduction/mastopexy also minimizes the amount of radiation therapy that needs to be delivered and reduces the risk of complications from radiotherapy.

Consultation and Procedure

During your consultation, Dr. Schwartz will evaluate your individual case and formulate a treatment plan that is right for you. Thanks to Dr. Schwartz’s access to a private Outpatient Surgery Center, his patients can expect to have their oncoplastic breast reduction surgery scheduled without delay.

Oncoplastic breast reduction, just like any other breast cancer diagnosis and treatment, is covered by your health insurance.

Often, patients are sent to the breast center (located just one floor below our surgery center) for placement of a small wire into the breast to help localize the breast cancer. Patients are then transported to our Outpatient Surgery Center where the wire, cancer and previously placed biopsy clip are removed.

The oncoplastic breast reduction/mastopexy procedure itself typically takes one to one and a half hours to complete, depending on breast size and is done under general anesthesia. No drains are placed, and patients are discharged home after surgery. Dressings are placed in the operating room which stay on until the following week when they are removed, and a sports bra is put on.

This surgery removes cancer and a small amount of the healthy tissue that surrounds it (“margin”). This ensures that all of the abnormal tissue is removed. The pathologist analyzes the margins to detect any possible cancer cells on the edge of the specimen. A cancerous margin is “positive”, while a healthy margin is “clean” or “negative”. Additional tissue can be removed during surgery if the margins are determined to be positive or close to avoid another surgical procedure. Sentinel lymph node biopsy (SLNB) or axillary lymph node dissection (ALND) is frequently also performed to determine if cancer has progressed away from the breast and into other parts of the body.

Recovery and Results

Recovery times after oncoplastic breast reduction vary depending on the individual but are typically short and patients can expect to return to their normal activities within a few weeks. Results from oncoplastic breast reduction/mastopexy are typically very good, with most patients achieving an excellent cosmetic outcome.

Your surgical or sports bra will need to be worn for 4-6 weeks following your oncoplastic breast procedure.  You should plan to be off work for 2-4 weeks, dependent on the type of work you perform.  

You also may feel pulling or stretching in your breast area. Although you may need pain medicine for a week or two, you can expect to feel better and stronger each day.

For several weeks, you may get tired easily or have less energy than usual. You also may have the feeling that fluid is moving in your breasts. This feeling is normal and will go away over time.

Your new breasts may feel firmer and look rounder. Breast reduction may change the normal feeling in your breast. But in time, most of the feeling returns to normal.

Keep in mind that it may take time to get used to your new breasts. You will have swelling at first, but the breasts will soften and develop better shape over time.

You are likely to feel well enough to return to work after 2 to 4 weeks, based on your progress. You can usually resume normal physical activities in this time frame as well.

You should expect some scarring following breast reduction surgery; however, these scars will gradually fade over time.