What is a breast reduction for breast cancer (therapeutic mammoplasty)?
A breast reduction for breast cancer (therapeutic mammoplasty) is an operation to make your breasts more even in shape or reduced in size. It is normally done at the same time as the surgery to remove breast cancer.
What are the benefits of surgery?
The cancer surgery alone may make your breasts uneven in shape and size or your breasts may already be uneven in shape and size (this is common). A breast reduction will aim to make them more even.
A breast reduction combined with removing the cancer may mean your breasts have a more normal shape long term.
If you have large breasts and need radiotherapy as part of your cancer treatment having a breast reduction may reduce your risk of complications from radiotherapy.
Are there any alternatives to surgery?
Your surgeon may be able to recommend an alternative to improve the size and/or shape of your breasts.
What will happen if I decide not to have the operation or the operation is delayed?
It is your choice to have a breast reduction. You do not have to have it on both sides, and it will not affect the outcome of the surgery to treat the cancer. Patients who do not have a reduction for breast cancer are at an increased risk of needing another operation.
You may have asymmetry between the two breasts or a less satisfactory breast shape.
If you have very large and ptotic (natural droop) breasts you may have an increased risk of complications from radiotherapy given as part of your treatment.
If you are booked in for a breast reduction as part of your cancer surgery, you should not have to wait too long. Your healthcare team will talk to you about this.
What does the operation involve?
The operation is performed under a general anaesthetic. It usually takes between 90 minutes and 3 hours, depending on whether you are having other procedures at the same time or not.
Your surgeon will make a cut on the breast. They will perform the breast cancer surgery and remove some of your excess breast tissue, fat and skin.
Your surgeon will reshape your breast and lift your nipple (if it can be preserved), so it is in a higher position.
If your breasts are large, your surgeon may also need to make a cut on the crease under your breast.
If your breasts are large or droopy, your surgeon may need to completely detach your nipple and areola and reattach them at a higher position.
How can I prepare myself for the operation?
If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health.
Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.
Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the breast cancer team or your GP for advice.
If you have not had the coronavirus (COVID-19) vaccine, you may be at an increased risk of serious illness related to COVID-19 while you recover. Speak to your doctor or breast cancer team if you would like to have the vaccine.
a The excess fat and skin are removed
b The breast is re-shaped and nipple is lifted
c An anchor-shaped scar
What complications can happen?
Some complications can be serious and can even cause death.
General complications of any operation
- bleeding
- infection of the surgical site (wound)
- allergic reaction to the equipment, materials or medication
- blood clot in your leg
- blood clot in your lung
- chest infection
Specific complications of this operation
- developing lump under your wound caused by blood collecting (haematoma) or fluid (seroma) inside a breast
- developing a hard lump in a breast
- numbness or continued pain on the breast or around the scars
- loss of skin, including the areola and nipple
- stiff shoulder
- loss or change of nipple sensation and/or reaction to cold or touch
- reduced ability to breastfeed
- cosmetic problems
Consequences of this procedure
- pain
- unsightly scarring of your skin
How soon will I recover?
You should be able to go home the same day or the day after.
You should be able to return to normal activities after 2 to 3 weeks.
You should be able to return to work after a week, depending on your type of work and any additional treatments.
Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the breast cancer team or your GP for advice.
Breast cancer reduction surgery scars improve gradually over time. Your breasts should become softer and more natural, and the scars should fade. The combination of cancer surgery, radiotherapy and a breast reduction may mean you develop some asymmetry over time.
Summary
A breast reduction is an operation to maintain a natural shape of your breasts and imrpve symmetry with breast cancer surgery. You should consider the options carefully and have realistic expectations about the results.
