Coping with life after mastectomy

Breast reconstruction can be done either at the same time as the primary operation (immediate reconstruction) or many months after primary surgery (delayed reconstruction).
There are different breast reconstruction options available depending on the individual, age, general fitness, type of breast cancer and any future treatment that may be necessary. Having an immediate reconstruction avoids the need of future surgery. Women who are likely to need radiotherapy after mastectomy may be advised to have a delayed reconstruction as radiotherapy could impair the result of reconstruction.
It must be noted that reconstruction is major surgery and should be considered carefully.

Oncoplastic breast surgery
Oncoplastic breast surgery is one of the most interesting and challenging developments in the last 20 years. The aims of this surgery are wide local excision of the cancer coupled with partial reconstruction of the defect in the breast to achieve a cosmetically acceptable result. Avoidance of mastectomy, consequent reduction of psychological morbidity and patient satisfaction are the principal goals in the development of various oncoplastic techniques.
Oncoplastic surgery allows large areas of the breast to be removed in carefully selected patients without the need for the patient to undergo a mastectomy.
In the US, breast reconstruction is primarily done by plastic surgeons. However, in UK, there are dedicated fellowships that allow breast surgeons to be trained in doing reconstructive and oncoplastic breast surgery
Oncoplastic surgery should not be either identified or confused with breast reconstruction which is done after mastectomy. While it is possible for a breast surgeon to perform a mastectomy and then allow the plastic surgeon to carry out the reconstruction, this is not feasible in oncoplastic breast conservative surgery, as it requires knowledge both of oncological and plastic surgery for a good oncological and cosmetic outcome.

The writer is the director, KIMS-Ushalakshmi Centre for Breast Diseases, Hyderabad