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Reconstruction, Restoration and Recovery After Breast Cancer

melanie lynch, md
Breast surgeon Melanie Lynch, MD, says newer oncoplastic approaches to breast cancer surgery and reconstruction allow breast cancer surgeons and plastic surgeons to deliver more cosmetically pleasing results to women while saving lives.

Every woman’s breast cancer journey is different, but for most, it begins with fear, shock and disbelief. In many cases, women simply want the cancer removed, no matter the cosmetic outcome – not realizing that newer approaches to breast cancer surgery and reconstruction are evolving and transforming lives.

Oncoplastic surgery is one of those approaches. While it is not something women commonly ask for by name, oncoplastic surgery combines the latest in plastic surgery with surgical oncology to provide women with a more aesthetically pleasing result following breast cancer surgery. In a back-to-back operation – often performed as an outpatient procedure – the tumor is removed, and the remaining breast tissue is reshaped to retain a more natural look.

“We talk about oncoplastic surgery in the realm of breast conservation,” said Melanie Lynch, MD, director of the Norma Pfriem Breast Center at the Smilow Cancer Hospital Care Center in Trumbull. “It’s really a philosophy about providing women with an operation that contributes to the cure of their breast cancer while respecting the integrity of their body and restoring their functional and aesthetic sense.”

Focused on cure

Curing breast cancer is usually top of mind for women diagnosed with the potentially deadly disease – so much so, that Dr. Lynch will sometimes need to coach them into meeting with a plastic surgeon for reconstruction.

That was true in the case of Nancy Macauda, a Trumbull resident, who was diagnosed with Stage 1A breast cancer in March 2021. “It’s scary. You hear the word ‘cancer,’ and you go blank. I remember thinking: ‘You’ve got breast cancer and you’ve got to get it out. No matter how you look, you are just going to have deal with it,’” Macauda said.

When she met with Dr. Lynch, she learned that she had options. Dr. Lynch introduced her to colleague, Anke Ott Young, MD, a plastic surgeon who received specialized training in oncoplastic surgery in Europe in 2006 and has been developing new techniques for patients undergoing breast cancer surgery at Bridgeport Hospital or the Park Avenue Medical Center in Trumbull.

Who are candidates for oncoplastic surgery?

Women who are good candidates for oncoplastic surgery are generally those whose treatment plan involves breast-conserving surgery, such as a lumpectomy or partial mastectomy, in which most of the breast remains intact. This may also include patients with larger breasts, those who have only one tumor or a tumor located away from the nipple and areola.

Dr. Lynch first meets with patients to go over their diagnosis and treatment plan, and if she thinks they are good candidates for oncoplastic surgery, she consults with Dr. Ott Young.

“When I do a simple lumpectomy, for example, I want to make sure I have the most cosmetic incision, and that I have reconstructed the breast so that it is round in shape and the nipple stays in the middle of the breast and matches the other side,” Dr. Lynch said. “If the amount of tissue that needs to be taken out is significant compared to the rest of the breast, or if the patient might benefit from a breast lift or breast reduction, I call Dr. Ott Young.”

It takes a team

“Oncoplastic surgery really only works when the two surgeons working together are cross-trained,” Dr. Ott Young said. “The plastic surgeon needs to be trained in general surgery or oncological surgery because you have to respect the tumor biology and the prognosis of the patient.

“It’s still an up-and-coming field,” Dr. Ott Young noted. “Unfortunately, it is not such a common setup; it has to be a very close team effort, and in a lot of places, there are not enough surgeons trained in this way. We’re fortunate to be here at Smilow, where we have plenty of expertise.”

“Today, with over 87 percent of women diagnosed with breast cancer achieving a cure and living a long life after their treatment, it is now really incumbent upon us as surgeons to make sure that our approaches to surgery respect the integrity of women’s bodies, and that women get a result they can live with for the rest of their lives,” Dr. Lynch said.

Read more about Nancy Macauda’s breast cancer journey and oncoplastic surgery.

Smilow Cancer Hospital, with Care Centers in Fairfield, Trumbull and Bridgeport, is dedicated to providing a comprehensive network of services for complete breast health and wellness. Read more about cancer services.