Oncoplastic Breast Surgery — Therapeutic Mammoplasty

Oncoplastic breast surgery is a hybrid approach that combines tumor resection with plastic surgical reshaping of the breast in a single operation. Therapeutic mammoplasty is a specific level-2 oncoplastic technique that uses standard breast reduction patterns (Wise, vertical, J-pattern) to remove cancerous tissue while preserving aesthetic shape and nipple position.

It is indicated for patients with macromastia, ptosis, large or unfavorably located tumors, and those who would otherwise require mastectomy. Symmetrization of the contralateral breast is often performed at the same time. Studies show oncologic outcomes equivalent to standard wide local excision plus mastectomy, with better cosmetic satisfaction and lower re-excision rates.

Patient selection includes preoperative MRI and 3D imaging, multidisciplinary review, and detailed discussion of incisions, scars, and risks of nipple-areolar ischemia. Postoperative radiotherapy is delivered as in standard breast conservation. Long-term follow-up includes mammography, ultrasound, and clinical breast examination.