Breast cancer surgery is a demanding field of plastic surgery. It calls for broad and comprehensive knowledge and substantial expertise in the fields of breast surgery, tumour surgery and microsurgery. In this context it is also referred to as onco-plastic surgery. The aim of breast cancer surgery is to provide treatment for the condition by removing the cancer. However, at the same time, the patient’s physical integrity must also be considered. We do this by aiming to achieve the most appealing and aesthetically pleasing result possible. A key focus of breast-conserving treatment is on maintaining quality of life. In the case of mastectomy, this is achieved by restoring the female form through breast reconstruction. Breast cancer treatment should thus be as radical as necessary, but as gentle as possible.
Primary goal: complete removal of the tumour
It is essential to gather all the information about the tumour before the first operation (mammogram, ultrasound, fine needle aspiration, punch biopsy, MRI), so that you can make the right decision together with your specialist. This also increases the chance that your first treatment will be successful and means that the number of subsequent operations can be restricted to the minimum necessary. The primary goal of breast cancer surgery is the complete removal of the tumour. Depending on the severity of the disease, the type of tumour, anatomical factors and the wishes of the patient, two different approaches are possible: breast-conserving surgery, or the complete removal of the breast (mastectomy) with immediate or delayed breast reconstruction.
Treatment to achieve the desired outcome
Irrespective of which approach is chosen, the guiding principle is that the treatment should achieve the desired results as quickly as possible. If, for example, breast conservation is inappropriate, this avenue should not be pursued at all, and mastectomy and breast reconstruction should be carried out instead. It is not uncommon for contra-indicated or poorly performed breast-conserving surgery to ultimately culminate in a mastectomy, either because tumour cells remained in the breast, or because the aesthetic result is unacceptable. This is a very painful and stressful experience for the patient, which they could have been spared.