Lumpectomy (Breast Conserving Surgery)

Immediate reconstruction after a lumpectomy may be an option in your area. This is often referred to as oncoplastic lumpectomy or oncoplastic breast surgery. Oncoplastic lumpectomy combines lumpectomy with reconstruction to reshape the breast, reducing any noticeable indents that can be left behind from traditional lumpectomy surgery.

There are three levels of oncoplastic lumpectomy in Canada¹:

Level 1: Level 1 procedures can be performed on individuals who require up to 15% of the breast tissue to be removed. It is a relatively simple procedure and may be more commonly performed by breast surgeons across Canada. Once the tumour and margins have been removed, the surgeon can reshape the breast using remaining tissue within the breast. With this procedure, surgeons can often strategically place the scar in a less noticeable area of the breast².

Level 2: Level 2 procedures are more specialized and can be performed on individuals requiring 15-25% removal of their breast tissue. This procedure can combine removal of the tumour and surrounding margins with:

• Level 1 volume displacement and reshaping techniques
• Fat grafting or tissue flap techniques outlined above
• And more traditional plastic surgery techniques including a breast lift (mastopexy) or reduction (reduction mammoplasty)

Level 3: Level 3 procedures are, again, more specialized and are performed on individuals requiring 25-60% removal of breast tissue. These procedures use traditional reduction mammoplasty techniques to remove large amounts of breast tissue. They also include surgery on the other breast to maintain symmetry.

Additional considerations:

• While common in Europe, oncoplastic lumpectomy is still an emerging field in Canada. Level 1 procedures may be more accessible and are able to be performed by many general breast surgeons. Coverage, eligibility, and availability of level 2 or 3 procedures may be more difficult to acquire because they require more specialized training. Ask your surgeon if this procedure is an option in your area.
• Clips marking the original location of the cancer will be placed in the breast during all oncoplastic lumpectomies. These clips allow your healthcare team to know exactly where the cancer was and are visible during breast cancer screening³.