A Lost Opportunity: Oncoplastic Surgery's Critical Role in Breast-Conserving Surgery

Abstract

The ultimate goal in reconstructive breast surgery is not just to restore normalcy but also to, ideally, leave a patient with an aesthetic outcome superior to her initial presentation. Oncoplastic reconstruction in the setting of breastconserving therapy (BCT) offers patients such an opportunity by reshaping the breast mound, addressing ptosis, and improving symmetry, which is far beyond just correcting the sequelae of tumor ablation. There has been an increase in the proportion of breast cancer patients receiving partial mastectomy and radiation therapy over the past 2 decades, in large part due to numerous prospective studies demonstrating equivalent outcomes to mastectomy for stage I and II breast cancer. Despite passage of the Women’s Health and Cancer Rights Act in 1999, which mandates insurance coverage for breast cancer reconstruction, Surveillance, Epidemiology, and End Results data demonstrate that U.S. reconstruction rates for partial and complete mastectomy remain disturbingly low, at around 40%. Considering advances in oncoplastic technique, women should be given increased access and counsel on oncoplastic reconstruction when receiving BCT due to significant benefits in cosmesis and quality of life with minimal risk of morbidity.