Surgery for Breast Disease

Mr Bonomi consults privately at Goring Hall Hospital every Thursday evening following the ONE STEP CLINIC approach.

On their first appointment patients will have mammogram, ultrasound (results are given on the same day) and biopsy if indicated. The result of the biopsy is normally ready in 4 working days and is given to the patient after discussing it at the Multidisciplinary meeting.

A dedicated Breast Care Nurse is present as a Key Worker during the consultation and the Breast Team is always available if any doubt or problem occur during the treatment pathway.
It is important to be aware of the cancer family history as it is not only breast cancer which can be genetically driven. Therefore, it is worthy to be aware of the relatives who have had cancer because you may be referred to be genetically screened.

His practice specializes in the treatment of benign breast changes, congenital abnormalities and cancer.

Treatment of benign breast disease and congenital breast abnormalities:

  • Lumps and bumps
  • Tuberous breast: a condition in which the breast developed with a shape different from the most common breast due to abnormal scar tissue

Treatment of deformities following breast cancer surgery or radiotherapy:
Sometimes surgery and radiotherapy can leave indentations and distortion of the breast skin. If the indentation is minimal Mr Bonomi will treat you using scarless techniques under local anaesthetic to release the scar responsible for the deformity. If the distortion is severe, he will offer fat graft to the breast. This technique consists in performing liposuction, taking fat from the areas where available or unwanted and then re-injecting the purified fat in the breast to increase the volume, improve the quality of the skin and release the internal scars.

Treatment of malignant breast disease in women and men:
Breast cancer is the most common cancer in women and being diagnosed with it is a traumatic experience. It is important to gain information from websites designed to help patients. For more information consult

  • Conservative surgery: removal of the disease preserving the breast
    In breast conservative surgery it is important to apply the whole spectrum of cosmetic reduction techniques in order to achieve the best possible cosmetic result, while treating the cancer. The aim of these cosmetic techniques is to maintain a breast shape with a natural contour. This is possible when the amount of breast to remove is between 20 to 40% of the breast volume.

Use of pedicled flap in conservative surgery: MICAP and LICAP flap
When the amount of breast tissue to remove is more than 40% of the total breast volume, then it is necessary to recruit tissue from other part of the body.
MICAP and LICAP are part of the skin and fat taken from the upper part of the tummy or the back of the chest to fill the cavity left after removal of the breast cancer.

  • Mastectomy with or without reconstruction
    When mastectomy is necessary, it is important to evaluate if the nipple and the skin envelope can be preserved as it is the best way of reducing the impact that this type of surgery has on the body image and the femininity of the women.
    Nipple sparing and skin sparing mastectomy are techniques that preserve the entire breast skin and associated with immediate reconstruction allow to achieve the best possible cosmetic result.
    The rigorous discussion of every patient in the weakly multidisciplinary meeting allows to decide whether these approaches are safe or more radical decisions need to be taken

Risk reducing surgery in high risk patients
Around 5% of breast cancer is genetic in nature and more genes have now been discovered. The most common ones are BRCA1, BRCA2, PTEN or CHEK2.

  • Breast reconstruction
    Mr Bonomi offers different types of reconstructions:

    • a composite reconstruction with silicone implant and fat graft
      This technique consists in performing liposuction, taking fat from the areas available or unwanted and then reinjecting the purified fat in the breast to increase the volume, improve the quality of the skin and release the internal scars.
    • Latissimus dorsi flap (skin, fat and muscle of the back) and fat graft
      If a patient had already had previous radiotherapy as part of breast cancer treatment it is better to avoid the use of implant and therefore the skin and the muscle of the back can be used to recreate the breast volume.

Breast reconstruction is not mandatory and lot of patients opt for simple mastectomy. There isn’t only one type of reconstruction which fits every patient. During the consultation all the types of reconstructions will be discussed.

For more information please consult