By Dr. Melissa Tan, Consultant Breast & Oncoplastic Surgeon, Prince Court Medical Centre
Receiving a breast cancer diagnosis is life-changing. However, it is important for women to know that a diagnosis does not automatically mean losing the breast.
Breast cancer treatment has evolved significantly, leading to improved survival and long-term outcomes. Modern care combines:
Local treatment: surgery and radiotherapy
Systemic treatment: hormone therapy, chemotherapy, targeted therapy, and newer treatments
Early detection of breast cancer can save lives and breasts. With better screening and early detection, more women are diagnosed at an earlier stage, allowing for breast conserving surgery (BCS) to be performed safely in suitable cases.
Research has shown that for early-stage breast cancer (Stages I–III), breast conserving surgery followed by radiotherapy provides survival outcomes equivalent to mastectomy, with better quality of life and patient-reported satisfaction.
Advances in breast cancer surgery now place equal emphasis on cancer control, breast preservation, and quality of life, offering many women safe alternatives to mastectomy.
Breast conserving surgery, also known as wide local excision or lumpectomy, involves removing the cancer while preserving as much healthy breast tissue as possible.
The goal is to:
Achieve complete cancer removal
Maintain breast shape and appearance
Reduce physical and emotional impact
Breast conserving surgery is often followed by radiotherapy to minimise the risk of recurrence.
A mastectomy involves removal of approximately 90–95% of breast tissue. Complete removal of all breast tissue is anatomically impossible.
A mastectomy may be recommended when:
Cancer cannot be removed safely while preserving cosmetically acceptable breast;
Radiotherapy is not suitable or declined by the patient;
Patient chooses mastectomy after counselling;
Patient has genetic mutation associated with high risk for developing more breast cancers;
Late presentation of breast cancer;
A rare type of breast cancer called inflammatory breast cancer is present.
Generally, there are four types of mastectomy.
Simple mastectomy
Removal of breast tissue without reconstruction. Patients have the option of using external breast prostheses in their bra.
Goldilocks mastectomy
Removal of the breast tissue. Then, the remaining fatty tissue and skin are shaped into a breast mound.
Mastectomy with breast implant reconstruction
Skin and sometimes the nipple can be preserved, with a breast implant placed immediately or later.
Mastectomy with autologous reconstruction
Reconstruction using the patient’s own tissue, commonly from the abdomen or back.
Oncoplastic breast surgery combines cancer removal with reconstructive techniques, allowing surgeons to remove larger tumours while maintaining breast shape.
Traditionally, cancers larger than 4-5 cm or occupying more than 20% of breast volume often required mastectomy. Advances in oncoplastic techniques now allow many of these patients to consider breast conserving options.
Less than 20% of breast tissue is removed.
The removed cancer space is filled with surrounding breast tissue.
Breast cancer is removed.
Breast reduction and lift (mammoplasty) is performed at the same time.
Breast cancer is removed and the space is replaced with chest wall fat tissue from below or side to the armpit or below the breast areas. These fat tissues are called chest wall perforator flaps.
Partial breast reconstruction with chest wall perforator flap is essentially a technique used by surgeons to fill the gap after the cancer is removed and give back what is removed.
Choosing breast cancer surgery is deeply personal and complex. Every option must be carefully assessed by trained Oncoplastic and Reconstructive Breast Surgeons, sometimes in collaboration with Plastic and Reconstructive Surgeons.
Breast conserving and oncoplastic surgery can:
Reduce physical disfigurement
Improve recovery
Support emotional, sexual, and psychosocial wellbeing
Lessen financial and lifestyle impact
Empowering women through shared decision-making allows patients and surgeons to agree on the most appropriate, individualised treatment plan.
At Prince Court Medical Centre, patients benefit from comprehensive breast care from diagnosis to surgery, reconstruction, and long-term follow-up.
If you have questions about breast conserving surgery, oncoplastic breast surgery, or mastectomy options, schedule a consultation with Dr Melissa Tan to explore personalised treatment options.Be the first in line to receive the latest updates and promotions, delivered directly to your inbox.
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