Breast cancer surgery
Follow up mammograms in healthy asymptomatic women have increased the detection of tumors with small diameters. When we diagnose a small diameter tumor at an early stage, the chances of conserving the breast are higher.
Early detection, thanks to periodic controls, associated with advances in cancer treatments, has been shown to reduce mortality from breast cancer.
Early diagnosis has allowed 60-70% of women with small or initial tumors to undergo surgery using minimally invasive techniques, conserving the breast and recovering their personal, family, and professional life in the shortest possible time.
The choice of treatment and surgical technique is decided considering the type of tumor and its diameter, the size of the breast, the single or multiple location of the lesion, as well as the possibilities of receiving complementary treatment with radiotherapy and other factors to be considered.
Lumpectomy is a surgical technique used by surgeons to resect or remove a tumor. During the procedure, the surgeon will try to obtain a healthy gland area around the tumor to try to obtain safety margins around the tumor and at the same time to preserve the breast. It is considered a “tumor free margin” when there are no malignant cells on the edge of the obtained resection piece.
Once the lumpectomy is performed, the team of pathologists analyzes the surgical piece during the same surgical act and verifies if the distance to the margins is adequate and determines if the margins are free of disease. This step is essential since it guarantees oncological safety and minimizes the need for reoperations.
The location of the scar must be carefully selected considering the size, shape of the breast, and tumor location.
The surgeon chooses the most appropriate approach, which will obtain perfectly safe results from the oncological point of view, and as satisfactory as possible from the aesthetic point of view.
Currently, we have many techniques to reshape the breast and maintain normal appearance after performing a broad lumpectomy or quadrantectomy. Once the lumpectomy has been performed and after the pathologist confirms that the margins are free of disease, we proceed to perform a glandular remodeling to improve the plastic result, as long as the size and volume of the breast allow it. This is called “oncoplastic surgery”.
Conservative treatment of breast cancer consists of performing a mild surgery (lumpectomy), subsequently associated with additional treatment with radiotherapy.
Radiotherapy treatment should be considered an integral part of conservative treatment. In very few selected cases can radiotherapy be avoided after conservative treatment.
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