A woman’s choice of treatment for a mass in the breast is incredibly personal. Oncoplastic surgery involves designing the operation to fit the patient: incorporating a woman’s goals for the operation, the size and location of the tumour, and the patient’s breast size and shape into the operative plan. It is very important for a woman to share with her surgeon what her cosmetic goals are for the operation. A woman may simply want her body to be restored as closely as possible to what was present before surgery. However, if a woman desires a lift with or without a reduction, this may often be incorporated into the surgical plan.

Furthermore, when the cancer involves more than one-quarter of the breast, it may be necessary to perform a lift/reduction as a means of avoiding a mastectomy.

LEVEL I ONCOPLASTIC LUMPECTOMY
Traditional lumpectomies involved placing the scar as close as possible to the cancer and allowing the cavity to fill with fluid. This often led the breast to heal with a depression or crater, especially after completion of radiation therapy. The goal of a Level I oncoplastic lumpectomy is to avoid this crater by shifting the surrounding breast tissue to fill that space. Furthermore, the scar may often be placed around the edge of the areola, under the breast, or in the armpit, so that the scar is hidden from view.

LEVEL II ONCOPLASTIC LUMPECTOMY
These procedures involve more advanced techniques for reshaping the breasts. They are often considered for women with large breasts or in cases where the breast tumour is larger.

As with other parts of the body, the skin of the breasts can stretch over time. This is called ptosis. Ptosis can be corrected by removing excess skin and lifting the nipple back to the centre of the breast—a procedure known as mastopexy.  This breast lift can be combined with a lumpectomy to improve the shape of the breast.

If a woman desires her breasts to be smaller, excess breast tissue can be removed along with the lift—a procedure known as a reduction mammoplasty.

Compared to standard lumpectomies, both Level I and Level II procedures remove more breast tissue around the tumour.  This is done to correct deformities and maintain breast shape.  This means that there is a smaller chance of the need for a second surgery to clean up the margins around the cancer.  These procedures may be perfect for women who have always thought about breast reduction. They not only have the outcome of smaller lifted breasts but also less back, neck and shoulder pain. Health insurance generally covers these procedures with a diagnosis of cancer.

• Improved Aesthetics: Preserves or enhances the natural appearance of the breast.
• Reduced Psychological Impact: Minimises the emotional impact of breast cancer by addressing body image concerns.
• Lower Risk of Recurrence: Enhances the completeness of cancer removal, reducing the risk of local recurrence.