Breast conserving operations aim to preserve as much of the breast tissue as is considered safe whilst leaving the breast in an aesthetically acceptable form.
This may involve a lumpectomy (also known as wide local excision, tumourectomy) where the cancer is removed with a margin of healthy breast tissue. The problem can be that this loss of tissue will leave the patient with a defect that will be visible if the tumour is moderate to large (more than 10 mm). Of course this depends on the size of the breast but volume defects will be noticeable in any breast and hence it is important to consider oncoplastic surgery where the breast tissue is rearranged to cover the defect.
In large breasts this could be combined with a breast reduction operation (known as therapeutic mammaplasty) and the other breast reduced at the same time or at a later date. This has obvious advantages in terms of appearance and quality of life. Surgeons should have received adequate training in these procedures or the consequences can be disastrous.
Sometimes large tumours can be shrunk by chemotherapy to avoid a mastectomy and make oncoplastic surgery feasible. The upper inner, lower inner and the lower outer parts of the breast are the unfavourable sites for poor cosmetic results.