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In order to start a correct treatment program preoperatively, it is not enough to know its result cytological examinationwhich only informs whether the cells are healthy or not, but it is necessary to carefully evaluate it Histology which, as I often tell my patients, allows us to accurately understand the characteristics of breast cancer.
The modern approach to surgery against breast cancer is oncoplasty.
Oncoplastic breast surgery: What is it for?
- To achieve the maximum possible local control of the disease.
- In using the techniques of aesthetic plastic surgery.
- In providing an excellent aesthetic result.
Breast oncoplasty techniques
Speaking of breast cancer surgery, the most modern techniques:
- Lumpectomy
- Conservative mastectomy, with preservation of the nipple and areola and immediate reconstruction, all in one surgery (with or without inserts, with or without mesh).
Lumpectomy
Lumpectomy is a conservative surgical procedure, consisting in the removal of the tumor in the breast, during which, in addition to the malignancy, a part of healthy tissue is also removed, thus offering the possibility of radical removal of the tumor and maintaining, at the same time, a normal appearance of it breast. To obtain it, it is often necessary to “reshape” the breast, with techniques derived from cosmetic surgery.
Conservative mastectomy
Today, the majority of mastectomies have a conservative approach, so we speak of a “conservative mastectomy.” Conservative mastectomy always involves radical removal of the mammary gland. There are many modern techniques, such as:
- Conservative mastectomy with preservation of the nipple. The skin of the breast and the nipple complex and areola are preserved.
- Skin Sparing Mastectomy. A small percentage of skin is removed and the nipple can be preserved. It is usually a technique we choose for large breasts or for breasts with sagging and drooping.
These mastectomy techniques allow immediate reconstruction in an operating room, if the necessary criteria are met, with implants, which is closer and closer to a normal breast in shape and size.
What criteria are necessary to decide the type of operation?
The surgical choice is formulated together with the breast surgeon and the woman informing her of the entire surgical and therapeutic course.
During the decision-making process, certain parameters will be evaluated, such as:
- the risk of recurrence of malignancy, derived from an analysis of the biological characteristics of the tumor, as well as of the patient
- anatomy, shape and volume of the breast
- the anatomical characteristics of the patient’s body
- quality and quantity of adipose tissue
- the possible need for other treatments such as, for example, radiotherapy
- the risk of postoperative complications
- the patient’s expectations in relation to the disease
Breast reconstruction after mastectomy
The modern trend today is to perform the reconstruction during the operation, at the same time as the removal of the malignancy, so that the patient has a very good oncological and cosmetic result in a single operation.
Breast reconstruction can be performed through:
- Inserts
- Dilators
- Krimnon
- Liposuction
- Hybrid restoration
Breast cancer treatment has evolved towards a holistic approach. Treatments vary from patient to patient, thanks to comprehensive protocols that provide personalized treatments.
There is also synergy between different specialties, such as:
- specialist breast surgeon
- Plastic Surgeons
- medical oncologist
- radiologist
- radiation therapist
- pathologist
- psychologist
- geneticist
- physiatrist/ physical therapist
In addition, the role of the breast surgeon has become highly specialized and capable of mastering all reconstructive techniques, with up-to-date expertise in oncology and reconstruction.
Let’s not forget prevention
We must remember that visiting a qualified breast surgeon and breast screening programs are the most important ways of prevention because, unfortunately, breast cancers are asymptomatic in their early stages.
October is the Breast Cancer Awareness Month and a reminder that prevention and early screening save lives. HYGEIA and MITERA, with their new campaign, try to remind every woman how important breast screening is in disease prevention, asking the simple question: “Have you been searched?”. So let’s make prevention our ally!