Partial breast reconstruction or reconstruction after lumpectomy

During a lumpectomy, a portion of the breast tissue is removed to treat a cancer or mass. The purpose of lumpectomy or breast conservation therapy is to treat the cancer or mass without having to remove the entire breast, like in a mastectomy. 

The amount of breast tissue removed during a lumpectomy can vary widely. Therefore, the results after lumpectomy are often unpredictable. This can leave a woman with a contour abnormality, deformity or asymmetry. This is especially true when radiation is part of the treatment plan.

Lumpectomy reconstruction or partial breast reconstruction, also known as oncoplastic reconstruction, is an option for patients who have had a lumpectomy and wish to recreate symmetry between the remaining breast and the other side. It can be performed at the time of the lumpectomy or many years later if a deformity exists.

There are numerous options for partial breast reconstruction, depending on the unique aspects of your case, the size and shape of the breasts and the amount of tissue removed. These options include rearranging the remaining breast tissue at the time of the surgery, transferring tissue from the back using the TAP flap or latissimus flap procedures, placing a breast implant, or performing fat grafting by harvesting your own fat with liposuction from other parts of the body.   

This type of reconstruction often involves a simultaneous breast lift or breast reduction on the affected breast as well as the opposite breast creating greater symmetry and improving overall cosmetic appearance.  

Although not always necessary, oncoplastic or partial breast reconstruction at the time of lumpectomy can be considered before surgery. Some patients are better off waiting until after their cancer treatment is complete while others will benefit from immediate reconstruction done in conjunction with a plastic surgeon. At Northwell, our interdisciplinary approach means that we’re able to offer this combined procedure to our patients.

To prepare for the surgery, you will first meet with a breast surgeon and then consult with your plastic surgeon so that they can coordinate your care together. The timing of this type of reconstruction is highly variable and needs to be determined based on your diagnosis, the stage of your cancer, the size and location of the mass or lump and the size and shape of the breasts, as well as any additional therapy that will be used, such as postoperative radiation. Together, you and your surgical team can make the best decision.

There are minimal additional risks involved in partial or oncoplastic breast reconstruction after lumpectomy.  Most of the risks are the same when undergoing lumpectomy alone without reconstruction. Some side effects may include decreased sensation in the nipples or residual asymmetry, especially when radiation is involved in the treatment plan for your cancer.

Lumpectomy reconstruction is usually an ambulatory procedure in an outpatient facility, which means you can go home the same day as your surgery. There may be some soreness and discomfort for a few days following the procedure, but patients typically return to work after a week.