EASTERN SUBURBS BREAST SURGERY
Oncoplastic Surgery
What is Oncoplastic Breast Surgery?
Oncoplastic breast surgery combines the principles of cancer surgery with plastic surgical techniques to achieve two goals simultaneously — complete removal of the breast cancer with clear margins, and the best possible aesthetic outcome for the breast.
Traditionally, breast conserving surgery focused primarily on cancer removal, with the cosmetic result treated as a secondary concern. Oncoplastic surgery changes that. By planning the cancer removal and the reshaping of the breast together — from the very beginning — it is possible to remove larger volumes of tissue, treat tumours in more challenging locations, and still achieve a natural, well-shaped result.
At Eastern Suburbs Breast Centre, oncoplastic planning is part of how we approach every breast conserving case. Our breast surgeons and plastic surgeons work together from your very first consultation, which means that when an oncoplastic approach is appropriate for you, it is built into your surgical plan — not added as an afterthought.
Who is Oncoplastic Surgery For?
Oncoplastic techniques are considered when standard lumpectomy alone might compromise either the cancer outcome or the cosmetic result. This includes situations where:
The tumour is large relative to the size of the breast
The tumour is in a location that would be difficult to excise without visibly distorting the breast — such as the lower pole, the inner breast, or behind the nipple
A wide margin of surrounding tissue needs to be removed to ensure clear margins
The patient has larger or more ptotic (drooping) breasts that lend themselves well to reshaping techniques
A standard lumpectomy has previously left an unsatisfactory cosmetic result
Oncoplastic surgery is not suitable for every patient. Your surgical team will assess your tumour, your breast anatomy, and your overall treatment plan to determine the most appropriate approach for you.
What Techniques Are Used?
Oncoplastic surgery encompasses a range of techniques, broadly divided into two levels of complexity.
Volume Displacement Techniques
These techniques use the breast’s own tissue to fill the space left after tumour removal, reshaping the breast to maintain a natural contour. They are most suitable for patients with medium to larger breasts. Examples include:
Therapeutic mammoplasty — the cancer is removed at the same time as a breast reduction or uplift, reshaping the breast into a pleasing form while achieving wide excision of the tumour. This is one of the most commonly performed oncoplastic procedures and can produce an excellent cosmetic result, often with a simultaneous reduction of the opposite breast for symmetry
Lateral tissue advancement, chest wall perforator flaps — tissue from the outer breast or chest wall is mobilised to fill a defect after cancer removal.
Volume Replacement Techniques
When there is insufficient breast tissue to fill the defect after cancer removal, tissue from an adjacent area may be used to restore volume and shape. The most common example is the latissimus dorsi mini-flap, which uses a small amount of muscle and fat from the back, tunnelled through to the breast, to replace the removed volume. This avoids the need for mastectomy in cases where the tumour-to-breast ratio would otherwise make breast conservation difficult.
The Role of the Opposite Breast
When significant reshaping of the operated breast is performed, it is common to offer a procedure on the opposite breast to restore symmetry. This may take the form of a reduction, uplift, or augmentation of the non-operated breast, performed either at the same time as the cancer surgery or as a planned second procedure once radiotherapy is complete.
Your surgical team will discuss whether a symmetrising procedure is appropriate for you, and at what point it is best timed in relation to your overall treatment.
Radiotherapy and Oncoplastic Surgery
Radiotherapy remains a standard part of treatment following oncoplastic breast conserving surgery, just as it is after a standard lumpectomy. The titanium clips placed by your surgeon at the time of the operation help the radiation oncology team accurately target the treatment field.
It is worth noting that radiotherapy can cause some further changes to the shape and volume of the breast over time. For this reason, any symmetrising procedure on the opposite breast is sometimes deferred until after radiotherapy is complete, so that the final result of the treated breast is known before any adjustments are made. Your team will discuss the timing that is right for your situation.
This page is intended as general patient information only and does not replace individualised medical advice. Please discuss your specific situation with your treating surgeon.
Private Expertise, Coordinated Care
All five of our surgeons hold appointments at two of Sydney’s leading public teaching hospitals. This keeps us at the forefront of evidence-based practice, clinical research, and multidisciplinary care. We bring that same standard of excellence to our private practice, with operating privileges across leading private hospitals throughout the Eastern Suburbs. Whatever your circumstances, you have access to a team working at the highest level.