Breast cancer reconstruction is an area of my practice which is rewarding as we are often able to successfully treat a patient’s breast cancer effectively, yet at the same time prevent a deformity of the breast or in some cases enhance the appearance of the breast. Elite athletes who have successfully completed IronMan/IronWoman triathlons are patients who are dear to…
The latissimus dorsi flap is an important and very versatile flap for breast reconstruction. The latissimus flap almost always requires a breast implant to add volume to the breast reconstruction in order to match the contralateral breast. The latissimus dorsi flap can be harvested and transferred with a skin paddle to replace a missing nipple areola complex or it can…
In certain patients with breast cancer, they may be a candidate for a lumpectomy with oncoplastic reconstruction and intra-operative radiation therapy. In patients with smaller tumors and certain biologic characteristics radiation can be undertaken at the time of lumpectomy during the operation. This can have fewer deleterious effects on the breast tissue, skin, and the overall aesthetic result. Oncoplastic reconstruction…
There are many different ways to reconstruct the breast following lumpectomy. Oncoplastic reconstruction of lumpectomy defects can provide excellent exposure for the oncologic breast surgeon to perform a lumpectomy and it can also allow the breast to be reconstructed in an aesthetic fashion. The mastopexy or breast lift component of the reconstruction can make a more compact target for radiation…
Tumors of the upper outer quadrant of the breast and with certain characteristics can be excised with lumpectomy, intra-operative radiation therapy, and oncoplastic reconstruction of the lumpectomy defect. In general, tumors that are amenable to lumpectomy and IORT tend to be less than 3 cm, estrogen receptor positive, unifocal, and have negative lymph node status. When a breast undergoes a…
When patients choose to undergo lumpectomy and when the cancer resides outside of the standard Wise mastopexy pattern, the pattern is sometimes adjusted to remove the skin above the tumor. This will help the oncologic surgeon remove the skin above the tumor and help to clear the anterior margin. When the incisions are sutured closed the final suture placed is…
Patients who have breast cancer may be a candidate for lumpectomy and intra-operative radiation therapy. The intra-operative radiation therapy is completed at the time of the lumpectomy and the lumpectomy defect is closed. The aesthetic outcome following this type of oncologic resection and reconstruction can have a great outcome.
When tumors are close to the nipple areola complex the nipple is often removed at the time of the lumpectomy to clear the anterior margin. When mammary prosthesis are in place, often the mammary prosthesis can be removed at the time of the lumpectomy procedure. Patients often choose to have their implants removed at the time of lumpectomy as they…
There are often times when patients may undergo a lumpectomy with an oncoplastic reconstruction of the lumpectomy defect and then in the future undergo a mastectomy. This may happen in patients who have a genetic mutation that puts them at higher risk for breast cancer. In these patients, the nipple areola complex may be preserved as it is re-positioned to…
Breast cancer that is treated with lumpectomy defects will often undergo radiation therapy. The radiation therapy can adversely effect the skin and tissue of the breast. Common changes can be atrophy of the skin and fat necrosis. The latissimus flap can be helpful to fill lumpectomy defects or defects that occur after removal of fat necrosis. The latissimus flap can…
