Dr. Fiona MacNeill: challenges in Oncoplastic Breast Surgery
Meet the Professor

Dr. Fiona MacNeill: challenges in Oncoplastic Breast Surgery

Received: 25 November 2017; Accepted: 28 November 2017; Published: 13 December 2017.

doi: 10.21037/abs.2017.12.02

October 21, 2017, the 12th Shanghai International Breast Cancer Symposium (SIBCS) successfully ended with wide-range scientific content and different categories. The Symposium started in 2005 and is aimed at providing a nationwide academic platform for breast cancer experts to have further communication and brainstorming.

During the meeting, we were honored to have an interview with Dr. Fiona MacNeill, Consultant Breast and Reconstruction Surgeon at the Department of Surgery, Royal Marsden Hospital, London, UK (Figure 1). Dr. MacNeill has dedicated her career to oncoplastic reconstructive surgery. As an invited speaker at the 12th SIBCS, she gave an excellent presentation on the topic “Oncoplastic surgeon? Oncology surgeon? Or both.”

Figure 1 Dr. Fiona MacNeill.

During the interview, Dr. MacNeill mentioned it was her patients who inspired her to become an oncoplastic surgeon. She was the only female surgeon in her hospital and she trained as a general surgeon but women with breast cancer came to see her because they were very distressed at the change in their body image and so Dr. MacNeill became interested in how to improve the appearance of breast cancer surgery nearly twenty years ago, that is how she started her journey to become an oncoplastic surgeon.

When it comes to challenges in Oncoplastic Breast Surgery, Dr. MacNeill said there are two main challenges at present. The first challenge is how to manage radiotherapy and reconstruction because the combination of radiotherapy and reconstruction is generally not a happy combination because radio therapy has a detrimental impact on any reconstruction. Her team at the Royal Marsden Hospital are trying to address this through research and have just set up a research trial giving radiotherapy before the mastectomy rather than giving radiotherapy after the mastectomy. The second challenge is managing the patients’ expectations because patients now see a lot of reality television and they think breast reconstruction is like breast cosmetic surgery. The patients need to know primarily the surgery is for cancer and it is a bonus if surgeons can also make them looking good as well.

As an outstanding female surgeon in a male normal donate a profession, Dr. MacNeill would like to say to young women surgeons: “Be true to yourself. Because as a woman you have very unique qualities that will enhance the care that you give as part of the wider team so I think you should be proud to be a woman and to celebrate those unique qualities that you bring to your patient care, your empathy, your understanding of the dilemma our patients find themselves in.”

Regarding the future trends of Breast Surgery, Dr. MacNeill said was less surgery. With the increasing use of primary systemic therapy and possibly primary radiotherapy she thinks there will be more breast conservation and therefore less need of mastectomy and axillary clearance and less need of complex reconstructive surgery.

Let’s enjoy the interview video (Figure 2).

Figure 2 Challenges in Oncoplastic Breast Surgery (1). Available online: http://www.asvide.com/articles/1889

Interview questions

  • Today your speech is about Evolving concept in implant reconstruction, would you please give us a brief introduction about new concepts in implant reconstruction?
  • What encourage you to become an Oncoplastic Surgeon?
  • Would you like to tell us what is the challenges in Oncoplastic Breast Surgery? And how to deal with these challenges?
  • Looking through the topics this year in Shanghai International Breast Cancer Symposium, which one impresses you most and why?
  • As an outstanding female surgeon in a male-dominated profession, what would be your suggestions you would like to share with female surgeons?
  • In your opinion, what are the future trends of Breast Surgery?

Expert’s introduction

Fiona MacNeill qualified from St Bartholomew’s Hospital, London in 1983. She was appointed as a Consultant in 1996, firstly at Colchester then in 2006 at The Royal Marsden Hospital London. Fiona joined The London Breast Clinic in 1996. She was Chairman of the Education and Training Committee, The Royal College of Surgeons of England and established sentinel lymph node training throughout the UK. President of the Association of Breast Surgery of Great Britain and Ireland from 2015–2017. Her main areas of interest are oncoplastic reconstructive surgery. In 2006, her educational and training achievements were recognized with the Silver Scalpel award. Fiona lectures nationally and internationally and is a member of a number of national and department of health committees.




Conflicts of Interest: The author has no conflicts of interest to declare.


  1. Zhang K. Challenges in Oncoplastic Breast Surgery. Asvide 2017;4:570. Available online: http://www.asvide.com/articles/1889

(Science Editor: Kate Zhang, ABS, abs@amegroups.com)

doi: 10.21037/abs.2017.12.02
Cite this article as: Zhang K. Dr. Fiona MacNeill: challenges in Oncoplastic Breast Surgery. Ann Breast Surg 2017;1:6.