When a woman is diagnosed with breast cancer, her first concern is to get rid of the tumor and be free of the disease. However, as she discusses her treatment with her physician, she will also want to know what type of surgery is likely to give her the best cosmetic results.

A new discipline called oncoplastic surgery addresses both of these concerns, combining the goals of oncology (treatment of cancer) with plastic surgery (reconstruction of the breast).

"As surgeons, we want to take out as much tissue as possible to be sure we've gotten all the cancer," explains Dr. Josef Haik, MD, Director of the Burn Unit and Senior Plastic Surgeon at Sheba Medical Center. "At the same time, we want to leave as much tissue as possible in order to conserve the breast. Both aims can be achieved with this approach."

Dr. Haik is among a select group of surgeons trained in this emerging field. "We want to provide the patient with the best possible outcome, and also ease the emotional trauma associated with breast cancer surgery," he says.

The two options for breast cancer patients are a mastectomy that removes the entire breast, and a lumpectomy that only removes the tumor, leaving the lymph nodes and surrounding breast tissue intact.

Traditionally, women with smaller breasts (B-cup or less) have chosen mastectomy followed by cosmetic reconstruction because they felt this would give them the most natural appearance. Many assumed that a lumpectomy would not leave them with enough breast tissue for cosmetic purposes. After surgery to excise the cancer, mastectomy patients may receive a prosthetic breast implant. Alternatively, they may undergo a procedure that uses a portion of their own abdominal fat and muscle to fashion a replacement breast.

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