Therapeutic Mammoplasty: A Fusion of Oncological and Aesthetic Breast Surgery (Breast Cancer) (Report‪)‬

Therapeutic mammoplasty, (the use of cosmetic breast reduction techniques in the oncological treatment of breast cancer) is gaining popularity amongst a growing cohort of 'oncoplastic breast surgeons'. Whilst the oncoplastic movement had focused largely upon the need for good post-mastectomy reconstruction, there is probably a greater requirement to ensure the excellence of cosmetic outcomes in the breast-conserving surgery situation. The only justification for breast conservation over total mastectomy is that of leaving a cosmetically acceptable breast for a patient, with the assumed concomitant reduction in psychological morbidity relative to total mastectomy. However, as we shall explain, the cosmetic outcomes from breast-conserving surgery are often far from excellent, and correction of poor aesthetic outcomes in this group of patients, who have largely had postoperative radiotherapy, is a major challenge. The oncoplastic surgeon must be primarily driven by oncological safety, but it is possible to achieve excellent aesthetics without compromise. However, consideration to both aspects must be given from the outset--if the initial resection is performed poorly, this has a major ongoing effect on any subsequent attempts to correct appearance.