Principes généraux de la chirurgie oncoplastique du sein

After a conservative treatment for breast cancer, 75% of patients end up with a good aesthetic result, i.e. little or no residual asymmetry and minor postradiotherapy after-effects. In 20 to 25% of cases, the conservative treatment leaves lasting after-effects associated with surgery and radiotherapy. Such aesthetic after-effects are difficult to treat and they require additional plastic surgery in 5 to 10% of cases. Oncoplastic surgery, which combines large lumpectomy and remodeling procedure involving different plastic surgery methods, improves these cosmetic results after a partial mastectomy and widens the scope for conservative treatment. Today, these techniques are well codified. They range from simple reshaping to more sophisticated techniques involving a concomitant controlateral-breast-symmetrisation procedure. These surgical options must be elaborated in detail with the patient and depend on the patient, the type of the tumor, its position, the ratio between the volume of the tumor and that of the breast and the overall care given by a multispecialist team. Plastic surgery is now an integral part of the treatment of breast cancer, hence the use of the word: oncoplastic surgery.