Breast reconstruction after breast-conserving surgery
About breast reconstruction after breast-conserving surgery
You do not usually need breast reconstruction after an operation to remove part of your breast (breast-conserving surgery).
But if you have a large amount of breast tissue removed, you may be offered reconstructive surgery. This can improve the appearance of your breasts or make them look more even. It can prevent problems developing with the appearance of the breast at a later stage.
Having breast reconstruction after breast-conserving surgery
Breast-conserving surgery and partial breast reconstruction can be done as:
- 1 operation (immediate reconstruction)
- 2 separate operations (delayed reconstruction).
As with any breast cancer operation, it is important to be sure all the cancer has been removed from the breast. The tissue removed will be carefully checked. If you have immediate reconstruction, and these checks show there may be some remaining cancer cells in the breast, you may need more surgery.
Possible operations to improve how the breasts look after breast-conserving surgery include:
- breast reshaping (mastopexy)
- partial breast reconstruction using your own tissue – this is called a TDAP flap (thoracodorsal artery perforator flap) or LICAP flap (lateral intercostal artery perforator flap)
- lipomodelling (fat transfer) – this is used to increase the size of the treated breast and to fill any dents.
LD mini-flap reconstructions
Breast reduction and reshaping
Breast reduction and reshaping may be an option if you have larger breasts and need to have part of your breast removed for cancer treatment.
After the cancer is removed, the remaining breast tissue is reshaped to create a smaller breast. This is called a therapeutic mammoplasty. You can have surgery to your other breast to make it smaller so your breasts match. This is usually done at the same time. But it may be done as a second operation.
Breast reduction and reshaping can:
- allow those with larger cancers or with large areas of DCIS (ductal carcinoma in situ) to have breast-conserving surgery
- increase the chance of removing the cancer completely in the first operation, compared with a standard lumpectomy (wide local excision)
- reduce problems, such as changes to breast size – for example, when the breast reduces in size after radiotherapy
- treat certain problems, such as shoulder and back pain, which are common in those who have larger breasts.
Right LD flap breast reconstruction and lipomodelling and nipple graft and left breast reduction
Right LD flap reconstruction with lipofilling and nipple graft and left breast reduction
Breast volume replacement
Another option is for the surgeon to put more tissue into the treated breast. This is called a breast volume replacement. This can be done by using a local flap of tissue from another part of the body such as a:
- LICAP (lateral intercostal perforator artery flap), which is more commonly used
- TDAP (thoracodorsal artery perforator flap), which is used less often.
It can also be done with lipomodelling.
These procedures are only available in some hospitals. So you may be referred to another hospital that has a plastic surgery department.
They are done by a surgeon that specialises in breast cancer and plastic surgery (oncoplastic breast surgeon).
About our information
-
References
Below is a sample of the sources used in our breast reconstruction information. If you would like more information about the sources we use, please contact us at cancerinformationteam@macmillan.org.uk
European Journal of Surgical Oncology. Oncoplastic breast surgery: A guide to good practice A. Gilmour et al. Published 5th May 2021. associationofbreastsurgery.org.uk/media/359061/abs-oncoplastic-guidelines-2021.pdf (accessed April 2023)
National Institute for Health and Care Excellence (NICE). Early and locally advanced breast cancer: diagnosis and management. Guidelines. July 2018. Last updated: April 2023. Available from: www.nice.org.uk/guidance/ng101 (accessed April 2023)
European Society for Medical Oncology (ESMO) Early breast cancer: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow up. Last updated 2019. Annals of Oncology 30: 1194–1220, 2019. Available from: www.annalsofoncology.org/article/S0923-7534(19)31287-6/pdf (accessed April 2023)
-
Reviewers
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by Senior Medical Editor, Professor Mike Dixon, Professor of Surgery and Consultant Breast Surgeon.
Our cancer information has been awarded the PIF TICK. Created by the Patient Information Forum, this quality mark shows we meet PIF’s 10 criteria for trustworthy health information.
The language we use
We want everyone affected by cancer to feel our information is written for them.
We want our information to be as clear as possible. To do this, we try to:
- use plain English
- explain medical words
- use short sentences
- use illustrations to explain text
- structure the information clearly
- make sure important points are clear.
We use gender-inclusive language and talk to our readers as ‘you’ so that everyone feels included. Where clinically necessary we use the terms ‘men’ and ‘women’ or ‘male’ and ‘female’. For example, we do so when talking about parts of the body or mentioning statistics or research about who is affected.
You can read more about how we produce our information here.
Date reviewed
Our cancer information meets the PIF TICK quality mark.
This means it is easy to use, up-to-date and based on the latest evidence. Learn more about how we produce our information.
How we can help