Receiving a breast cancer diagnosis turns everything upside down. Very quickly comes the essential question: who should I entrust my surgery to? Not all surgeons are trained the same way, and specialisation has a direct impact on the oncological outcome, the aesthetic result, and the overall quality of care.
Choosing your surgeon becomes one of the most important decisions. A consultation with a specialised breast surgeon helps confirm the strategy and prepare calmly for what follows.
When you learn you have breast cancer, choosing your surgeon suddenly becomes one of the most important decisions you will make. And yet, few patients truly know what distinguishes an experienced senology surgeon from a general surgeon. All websites look alike. All practitioners speak of "expertise". How can you really tell the difference?
The reality is that breast cancer surgery is a true sub-specialty in its own right, requiring specific training (in comprehensive cancer centres), regular practice, and mastery of modern techniques such as oncoplasty, the sentinel node, or immediate reconstruction. Not all authorised surgeons have the same training pathway nor the same dedicated experience in breast surgery.
This article is not intended to direct you towards any particular surgeon. It gives you objective criteria to evaluate the profile of the surgeon you will consult, to ask the right questions, and to feel legitimate in asking for a second opinion if necessary.
Dedicated breast cancer consultation · Usual delay 48 to 72 hours maximum
Beyond the diploma, these six elements help you concretely evaluate the profile and practice of the surgeon you are consulting. Do not hesitate to discuss them during your consultation: a serious surgeon will answer these questions with transparency.
Initial training in gynaecology-obstetrics or general surgery, complemented by a pathway in a comprehensive cancer centre and/or a DESC in gynaecological cancer surgery. Surgical senology cannot be improvised: it is a sub-specialisation validated by a dedicated curriculum.
A surgeon who regularly operates on breast cancer masters the nuances of every situation: central tumour, multifocal, young patient, BRCA mutation, recurrence… Regularity makes the quality of the gesture, the operative judgement and the decision-making.
Only institutions holding INCa authorisation can legally perform breast cancer surgery in France. This authorisation requires a minimum annual activity threshold and a structured multidisciplinary framework. This is the first thing to check.
The Multidisciplinary Team meeting (MDT) brings together a surgeon, oncologist, radiation oncologist, radiologist, and pathologist around your case. It is mandatory for any breast cancer and ensures no decision is made in isolation. You must have written confirmation of this.
Oncoplasty, sentinel node, immediate reconstruction, ERAS (enhanced recovery after surgery): these techniques are not universally mastered. Yet they radically change the aesthetic outcome and the quality of life after the operation.
Specialised anaesthetists, nurse coordinators, psycho-oncologists, lymphoedema-trained physiotherapists, areola pigmentation, patient associations… The ecosystem around the surgeon matters as much as the surgeon themselves.
Breast surgery is today recognised as a surgical sub-specialty in its own right. It relies on constantly evolving techniques and close coordination with medical oncology, radiotherapy, radiology, and pathology.
Modern surgical senology has evolved considerably over the past twenty years. Techniques of oncoplastic conservative surgery, the sentinel node, immediate reconstruction, enhanced recovery or strategies adapted to BRCA mutations require dedicated training and regular practice to be mastered safely.
This specialisation is generally built through a pathway in a comprehensive cancer centre or a specialised university hospital department. It can be validated by recognised additional diplomas, such as the DESC in gynaecological cancer surgery, which certifies specific training in gynaecological and breast cancers beyond the initial specialty.
When you consult a surgeon for breast cancer, do not hesitate to ask about their training pathway, what proportion of their activity is dedicated to breast surgery, and what modern techniques they practise on a daily basis. A serious surgeon will answer these questions with transparency and kindness — it is itself the sign of a quality approach.
A breast surgeon does not only treat cancer. Their training covers the full spectrum of breast pathologies, ensuring a complete view of the breast — from diagnosing a simple lump to reconstruction after oncological surgery.
Fibroadenomas (the most common benign tumours in young women), complex breast cysts, intraductal papillomas, mastitis and abscesses, mastopathies, nipple discharge. Most do not require surgery: the senologist determines when intervention is needed and when surveillance is enough.
See all benign breast pathologies →Atypical ductal hyperplasia (ADH), ductal carcinoma in situ (DCIS), lobular neoplasia. Neither fully benign nor cancerous, these lesions require precise senology expertise to evaluate the real risk of progression and tailor management.
For patients carrying a BRCA1/BRCA2 mutation or with a high familial risk, the senologist offers and performs prophylactic mastectomies combined with immediate reconstruction.
Learn more about prophylactic mastectomy →After breast surgery, correction of the opposite breast (reduction, mastopexy, lift) is part of the complete senology pathway. Breast reconstruction can be immediate or delayed depending on treatments.
This versatility is rare. Many surgeons focus only on cancer, or only on aesthetics. A true senologist covers the entire spectrum — which allows them to evaluate the breast as a whole, and anticipate both the oncological and aesthetic outcome from the very first consultation.
A second senology review allows to confirm or refine the proposed surgical strategy. A normal step, not a sign of mistrust. Bring your complete file (biopsy, imaging, MDT report).
The French regulatory framework around breast cancer surgery aims to guarantee a minimum quality threshold. These standards apply to all surgeons and all institutions.
Requesting a second opinion is not a rejection of the initial surgeon: it is a right guaranteed by law, and a normal approach before a major intervention. Here are the situations where it is particularly recommended.
Dr Jeremie Zeitoun holds a DES in gynaecology-obstetrics and a DESC in gynaecological surgical oncology, dedicated training in the surgical management of gynaecological and breast cancers.
No. In France, only institutions holding the INCa authorisation for breast cancer surgery can legally perform these procedures. This authorisation is based notably on a minimum annual activity threshold. Within authorised institutions, the quality of care then depends on the surgeon's senology specialisation, the regularity of their activity dedicated to breast surgery, and the modern techniques they master.
A senology-specialised surgeon has completed their initial training (gynaecology-obstetrics or general surgery) with a dedicated pathway in breast pathology, often undertaken in a comprehensive cancer centre, and validated by additional diplomas such as the DESC in gynaecological cancer surgery. They master modern techniques in breast surgery: oncoplasty, sentinel node, immediate reconstruction, BRCA mutation management. Their practice is largely or exclusively dedicated to breast surgery.
The MDT (Multidisciplinary Team meeting) is required by the French cancer plan to ensure each case is discussed collegially by a surgeon, medical oncologist, radiation oncologist, radiologist, and pathologist. It protects against isolated decisions and ensures a strategy validated by the entire team. Before any breast cancer surgery, you must have confirmation that your case has been reviewed at MDT.
Oncoplasty combines in a single operative procedure the complete excision of the tumour (oncological component) and aesthetic remodelling of the breast (plastic component). It helps preserve a harmonious breast shape after surgery, sometimes through contralateral symmetrisation. Not all surgeons practise oncoplasty: this is an important criterion if you wish to avoid breast deformity after conservative surgery.
Yes, this is a right guaranteed by law. Requesting a second opinion does not offend any surgeon: it is a normal approach before a major intervention. You can present yourself with your complete file (biopsy report, imaging, correspondence) to obtain a second reading of the proposed strategy.
For the majority of breast cancers, the recommended interval between diagnosis and surgery is 4 to 6 weeks maximum. This delay allows for staging investigations, anaesthesia consultation, and MDT review. A delay exceeding 6 weeks without medical justification should raise concerns.
The main criteria are: the surgeon's senology specialisation (training in a comprehensive cancer centre), the institution's INCa authorisation, systematic MDT review, mastery of modern techniques (oncoplasty, sentinel node, immediate reconstruction), the quality of the multidisciplinary team, and the quality of listening during the preoperative consultation.
To go deeper into understanding breast cancer surgery and the care pathway.
Diagnosis, types of cancer, treatment options and care pathway from A to Z.
BiopsyHow long before results, how to interpret them, what to do while waiting.
BiopsyCore needle, vacuum-assisted, surgical biopsy: which technique for which lesion.
TechniqueThe alternative to classic axillary clearance: indications, procedure, recovery.
ReconstructionImplant, DIEP, latissimus dorsi, lipofilling: understanding the techniques to decide calmly.
BRCAIndications, procedure and immediate reconstruction in women with BRCA1/BRCA2 mutations.
If you have just received a diagnosis, Dr Jérémie Zeitoun offers a dedicated consultation at his practice in the 8th arrondissement of Paris or at Clinique Hartmann in Neuilly-sur-Seine. Usual delay: 48 to 72 hours maximum.