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Oncoplastic Surgery: Plastic Surgery Techniques Used for Breast Cancer Patients

By: Lauren McRae

Katherine Kopkash, MD, Oncoplastic Surgeon at NorthShore, has always enjoyed her rewarding and challenging career as a doctor. She works with patients after a breast cancer diagnosis to determine the best outcomes through surgery. Her goal as a breast cancer surgeon is to "cure cancer in the most beautiful way possible," she says.

Katherine Kopkash

“My research interests are based on surgical innovation regarding breast cancer treatment and quality of life for breast cancer survivors. Breast cancer, when caught early, is a very curable disease. Therefore, we have to strive to treat it in a way that gives women an excellent quality of life, because we know they will live a big beautiful life after their breast cancer is cured,” she says.

Kopkash specializes in breast oncoplastic surgery, a term used to describe treating breast cancer with techniques that focus on an excellent cosmetic outcome. The surgery focuses on removing cancer while maintaining natural breast shape and appearance.

"I work very closely with my plastic surgery colleagues, often employing a 'team' approach for my larger or more complex cases, and we always utilize a dual surgeon approach when doing a mastectomy with reconstruction," she said. 

So how does Kopkash and the Center for Breast Health team determine an ideal candidate for oncoplastic surgery? “I analyze a patient’s breast imaging and pathology report to determine what are the best treatment options for their cancer. I talk with and examine the patient to understand the goals of care for them personally. Then, we come up with an individualized plan specific to their goals and their cancer.” she says. “Really, every patient can benefit from basic oncoplastic surgery techniques.”

If cancer is found on a screening mammogram, Kopkash and her team use imaging guidance to place a tiny radioactive seed into the tumor. Then, in the operating room, they use a probe that picks up radioactivity to show exactly the location of cancer so they can remove it. "During the surgery, while the patient is asleep, we image the breast tissue we removed in the operating room to make sure we have clear margins," she said.

For patients who do not currently have breast cancer but know they’re at an increased risk, Kopkash recommends three pathways:

  • Increased surveillance, which involves mammography and MRI every year, alternating the studies by 6 months. 
  • Taking medication to reduce your breast cancer risk, which is also called chemoprevention.
  • Prophylactic or preventative surgery, such as a bilateral nipple-sparing mastectomy with reconstruction.

“Oncoplastics gives patients gold standard oncologic outcomes and improved quality of life as a survivor due to less breast asymmetry. A truly great combination!” said Kopkash. “I love seeing patients at their post-op visit! Getting to tell someone their cancer was successfully removed during surgery and seeing how happy they are with the cosmetic result is very rewarding.”