Large breast cancers are usually treated with mastectomy, as the appearance of the breast may be very abnormal if large areas of tissue need to be removed. However, sometimes it is possible to do a lumpectomy and immediate reconstruction. This procedure is known as a mini-flap. First a wide local excision is done, which removes the area of breast cancer and a surrounding healthy area of tissue. When it is certain that all the cancer has been removed, the latissimus dorsi muscle is removed and tunnelled into the breast to fill the hole that was created by removing the cancer.

The surgery to move the latissimus dorsi muscle is done through a tiny cut in the skin either under the armpit or at the very side of the breast. This procedure does not cause any extra scars in the breast and the appearance of the breast is usually very good. Radiotherapy to the breast is usually given after this operation.

Lumpectomy followed by radiotherapy (breast conserving treatment) is a commonly used treatment for breast cancer and is explained in the breast cancer section. Up to 1 in 5 women will find that the treated breast is smaller than the other. In this situation it may often be possible to match the breasts by making the opposite breast smaller. The lost tissue in the treated breast can also be replaced by a skin and muscle flap (most commonly a latissimus dorsi flap).