A full guide to who is suitable for oncoplastic breast surgeries | Who is OBS for?
In the UK, around 55,000 women and 370 men are diagnosed with breast cancer every year. There are various types of breast cancer treatments to remove the tumour, and maintain a desirable breast shape and size. Occasionally, surgeons and patients favour oncoplastic breast surgery techniques, such as the TDAP, LICAP, therapeutic mammoplasty, and LTAP flap surgeries; but first, it is important to assess your suitability.
This guide will summarise the different oncoplastic breast surgeries, and their suitability for breast cancer patients.
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- Who is LICAP flap suitable for?
- Who is TDAP flap suitable for?
- Who is LTAP suitable for?
- Who is therapeutic mammoplasty?
Who is LICAP flap suitable for?
LICAP (or Lateral Intercostal Artery Perforator flap) surgery aims to maintain as much of the natural breast shape as possible after breast cancer surgery. During this type of oncoplastic breast surgery, the plastic surgeon will replace the lost breast tissue removed during the cancer excision. This new tissue is taken from the patient’s arms to reconstruct the space after removing the tumour.
Like all oncoplastic breast surgeries, LICAP flap tends to be more effective for certain candidates. LICAP flap may be more suitable for patients whose breast cancer is on the outer part of the breast. In addition, as the surgery requires the removal of tissue underneath the arm, a suitable candidate would have a healthy amount of breast tissue available; preferably, breast cancer patients with small to medium-sized breasts.
Who is TDAP flap surgery suitable for?
TDAP (or thoracodorsal artery perforator flap) is a piece of skin and fat which can be removed by a surgeon from the chest wall or the back. TDAP flap surgery will best suit breast cancer patients with small to medium-sized breasts. This is because the amount of skin and tissue required is typically much less than other procedures, and enough healthy tissue that can be removed from the lateral chest wall area.
After treatments such as the skin-sparing mastectomy, a breast implant can be inserted to help with the breast symmetry and loss of space. However, oncoplastic breast surgery retains as much natural tissue as possible. In TDAP flap surgery, skin and fat from the lateral chest wall are taken and transferred to the breast area, resulting in no need for breast implants.
Who is LTAP flap surgery suitable for?
The lateral thoracic artery perforator (or A) LTAPflap surgery aims to replace the lost breast tissue after breast cancer surgery; in combination with a lumpectomy. After removing the tumour, the surgeon will make an excision in the lateral chest wall (underneath the armpit). The flap of tissue from the lateral chest wall is then attached to the breasts in order to fill the gap left by the lumpectomy, and blood is supplied from the lateral thoracic artery.
Similarly to TDAP flap surgery, LTAP will best suit breast cancer patients with small to medium-sized breasts. It is also favourable if the tumour occupies more than 10% of the breast volume, and is located on the outer part of the breast tissue.
Who is therapeutic mammoplasty suitable for?
Therapeutic mammoplasty is a form of breast conserving surgery that is a modified breast reduction operation. After the lumpectomy, the surgeon removes additional breast tissue to achieve a smaller and uplifted shape, avoiding the risk of a defect left by the wide local excision.
As breast reduction will be involved, therapeutic mammoplasty will best suit breast cancer patients with moderate to larger breasts. This is because existing breast tissue will be used to reshape the breast to preserve its natural shape. However, therapeutic mammoplasty can also be performed in smaller breasts if there is laxity or droop to the breast.
Therapeutic mammoplasty is also a good alternative for breast cancer patients whose breasts are to large or heavy for other oncoplastic breast surgeries. If a breast cancer patient is unsuitable for surgeries such as the LICAP flap or TDAP flap, they may want to consider therapeutic mammoplasty.
Make sure to consult a specialist surgeon who can advise you on the different types of breast cancer treatments, and find the best outcome for your needs.
Comparing oncoplastic breast surgery suitability
The suitability of certain oncoplastic breast surgeries may depend on certain factors. The table below summarises each surgery and when it is appropriate.
|Type of breast cancer reconstruction||What does this involve?||When is it appropriate?|
After the tumour is removed, tissue is removed from the side of the torso beneath the armpit area to help reconstruct the breast.
Suitable for breast cancer patients where the tumour is on the outer part of the breast.
After the tumour is removed, skin and fat is removed from the lateral chest wall for partial breast reconstruction.
Suitable for breast cancer patients with small to medium sized breasts to treat cancers in any part of the breast.
After the tumour is removed, a flap of tissue from the lateral chest wall, which is supplied with blood from the lateral thoracic artery to fill the gap.
Suitable for breast cancer patients where the tumour is on the outer or central portion of the breast and occupies more than 10% of the overall breast volume.
After the tumour is removed, healthy breast tissue is used to reconstruct the breasts.
Suitable for breast cancer patients with larger breasts who are willing to undergo breast reduction.
Make sure you are undergoing the right breast cancer surgery by speaking to your doctor or specialist surgeon. Contact Stephen McCulley today to arrange a consultation to see if you are a suitable candidate for any of these oncoplastic breast surgeries.