Breast Oncoplastic Surgical Oncology

Dr. Abraham began practicing breast surgical oncology in 1995. In 2011, she added oncoplastic procedures to her practice. She attended a hands-on workshop taught by leaders in the field. She worked with a leading local plastic surgeon to hone her techniques. Competence is divided into levels of complexity and amount of training required. She has now attended two Oncoplastic hands-on courses, and can now offer Level 2 procedures to all of her patients. This is a relatively new field that combines the oncologic treatment of breast cancer with the principles of plastic and reconstructive surgery. This is one of the newest directions in breast conservation. The overall concept is to avoid disfigurement of the breast. This approach takes into account the oncologic safety of various procedures, as well as the anatomic considerations and preservation of form and function.

The choice of procedure is based largely on the location of the tumor and the size and shape of the breast. Traditionally, tumors located in the lower breast were associated with significant ‘bird’s beak’ deformity. Now, by careful placement of incisions, mobilization of the remaining tissue to replace lost volume, and moving the nipple up, we can avoid this. A procedure on the opposite side may also be required to restore symmetry. The goal is to keep the nipple-areolar complexes even and maintain a normal shaped breast mound.

Breast surgeons with Level 2 training are routinely performing traditional breast reductions. In general, we try to avoid any future surgery on a radiated breast. For this reason, women who present with preexisting symptoms of back and neck pain due to their large breasts benefit from having their symptoms addressed prior to the radiation therapy that is associated with breast conservation. The oncologic principles of clear margins and axillary staging are included. Significant ptosis can also be corrected. This is a very exciting new direction in the management of breast cancer. The law mandates these procedures be covered by insurance, since they are part of breast cancer care. A breast reduction on the contralateral breast, to recreate symmetry, is an example of a covered procedure.

For reconstructive procedures following a mastectomy, which are Level 3, she works with several excellent plastic surgeons.


You've got questions about breast surgery and we've got answers.

Get Answers