Advances in Breast Cancer Surgery Treatment Mean Fewer Mastectomies

Advances in breast cancer surgery treatment and research mean fewer mastectomies, as the University of Alberta increases its team of oncoplastic breast surgeons and continues to push the frontier of breast cancer research.

28 October 2019

Advances in breast cancer surgery treatment and research mean fewer mastectomies, as the University of Alberta increases its team of oncoplastic breast surgeons and continues to push the frontier of breast cancer research.

Dr. Lashan Peiris, Oncoplastic and Reconstructive Breast and General Surgeon, says, "Oncoplastic breast surgeons have a basic skill set, which will mean that women diagnosed with breast cancer not only have their tumour safely removed, but reconstruction of the resulting defect to enable them to have the best cosmetic outcome - and therefore ongoing quality of life."

Dr. Nikoo Rajaee joins the department on Nov.4, doubling the number of oncoplastic breast surgeons in the Division of General Surgery, which is considering adding a third next year. Oncoplastic surgery combines the latest plastic surgery techniques with breast surgical oncology.

Dr. Rajaee is a General and Breast Surgeon starting at the Misericordia Community Hospital on Nov 4, 2019. She completed her medical training at the Michael G DeGroote School of Medicine at McMaster University, followed by General Surgery Residency at the University of Ottawa. Dr. Rajaee was a Breast Surgical Oncology Fellow at the University of Toronto, and practices as a breast oncology and oncoplastic surgeon. Academically, she is pursuing her Masters of Health Evaluation at the University of Waterloo and is concentrating on process and outcome evaluation for hospital-based and surgical programs.

Regarding surgical management of breast cancer, Dr. Rajaee says, "We are moving away from routinely doing mastectomies for large breast tumours. We can preserve the breast with a variety of surgical options and better cosmesis, which ultimately improves the quality of life."

Adjuvant therapies have improved breast cancer survival rates over the past few decades. Increased quality of life for breast cancer survivors has been associated with breast conserving surgery, as has long-term cosmesis. "Oncoplastic surgery is an oncologically safe option and provides other reconstructive options for patients," Dr. Rajaee says.

Classically, large tumours or tumours with skin involvement were thought to require a mastectomy. Furthermore, patients perceived mastectomy as being the best option for oncologic outcome. Dr. Rajaee says, "We now know that with adjuvant therapy, local recurrence rates are similar, and should also consider cosmesis in our surgical planning. With oncoplastic volume displacement and replacement techniques, patients have more surgical options and those with larger areas of disease are also candidates for breast conserving surgery."

Edmonton Breast Surgical Oncology Meeting.

Dr. Rajaee attended the Edmonton Breast Surgical Oncology Meeting, which was held in October to coincide with breast cancer awareness month. Dr. Peiris organized it and it and was aimed at updates and controversies in the multidisciplinary management of breast cancer.

Dr. Dick Rainsbury, an oncoplastic and reconstructive breast surgeon and former president of the UK Association of Breast, gave an excellent presentation on setting up a specialist breast practice in the UK as well as extending the boundaries of breast conservation surgery.

Dr. Angel Arnaout, Regional Director of Breast Surgical Oncology and Oncoplastic Surgery, lectured on optimizing physical, psychosocial and quality of life when considering mastectomy incisions.

Dr. Renee Hanrahan, oncologic and reconstructive breast surgeon, Royal Victoria Hospital, Barrie, Ontario gave an update lecture on the Ontario guidelines for managing high risk breast lesions and a summary of recent advances in the management of the axilla after neoadjuvant systemic treatment.

Dr. Peiris says, "Next year will see a return of the interactive live-surgery masterclass with oncoplastic surgery broadcast from the operating room at the Cross Cancer Institute to attendees in the lecture theatre at the Kaye Edmonton Clinic with simultaneous didactic lectures."