A Step Towards Parity
The Oncoplastic Breast Consortium (OPBC) is an independent, international nonprofit organization led by a coalition of world-class surgeons working to bring safe and effective oncoplastic breast surgery to routine patient care. OPBC aims to continuously improve oncoplastic breast surgery by bringing international experts together, promoting high-quality education and performing international multicenter studies.
We are thrilled to report that OPBC has just added “optimal flat closure” to their mission statement, recognizing flat closure as an oncoplastic procedure deserving of an aesthetic surgical approach alongside breast preservation and reconstruction. This is an important step forward towards parity for flat closure.
The Oncoplastic Breast Consortium (OPBC) consists of breast cancer surgeons from gynecologic oncology, general and plastic breast surgery and a strong patient advocacy group. The consortium focuses on oncoplastic breast conserving surgery, nipple/skin sparing mastectomy with immediate reconstruction and optimal flat closure after conventional mastectomy.– OPBC
The Scope of Oncoplasty Includes Flat Closure
Oncoplastic surgery combines oncologic techniques (to remove the cancer) with plastic techniques (to reconstruct a contour – a breast mound, or the chest wall). The initial focus of this field was improving cosmetic outcomes for lumpectomy (also known as breast conserving surgery). A traditional lumpectomy excises the lump and closes the incision without any additional contouring, which can leave behind a permanent “dent.” Oncoplastic techniques contour the remaining tissues to avoid leaving dents (often paired with a symmetry operation on the healthy breast), resulting in better cosmetic result that patients are happier with. (Image: Kronowitz SJ et. al.)
Flat closure is a natural next step for oncoplastic focus. Simply removing the breast tissue often does not produce an optimal flat result, especially for patients with larger bodies and/or breasts (see right). Patients going flat are much happier when their surgical team takes an aesthetic approach, planning the excision and spending additional time contouring to produce a smooth, flat chest wall.
Why Does It Matter if Flat Closure is Considered Oncoplastic?
Categorizing flat closure as oncoplastic surgery counteracts the prevailing myth that women going flat “don’t care how we look” – a notion which contributes to poor outcomes for upwards of 15% of women who choose to go flat. It represents major progress toward widespread acknowledgment of flat closure as a reconstructive choice deserving of an aesthetic surgical approach, on par with traditional reconstruction.
We are proud to support and endorse OPBC’s goal of bringing oncoplastic breast surgery – including optimal flat closure – to routine patient care. And we look forward to continuing to work together with all stakeholders, including the OPBC, to ensure that women who choose to go flat after mastectomy receive optimal surgical results.
“Oncoplastic surgery is integral to all breast cancer surgeries. The use of an aesthetic approach to breast conservation or mastectomy greatly enhances the range of options that can be offered to women with breast cancer and facilitates better outcomes from it. It should be the standard of care.“– R. Douglas MacMillan, Nottingham Breast Institute