What is breast conserving surgery?
Breast-conserving surgery implies removal of the breast cancer zone along with a certain part of the peripheral healthy tissue to ensure integrity of the rest breast tissue. Since means of early diagnosis have improved for the breast cancer, it can be considered and preferred for many patients. The lymph nodes of armpits are also evaluated during the surgery. Ability to perform breast-conserving surgery depends on certain factors, such as type and size of tumor, the extent of invasion of the breast and other particular breast factors. Oncoloplastic surgery techniques help reconstruction of breasts even in case of large lumps. Breast-conserving surgery can be performed for almost all early-stage breast cancers, but it can be considered, if preoperative chemotherapy makes advanced-stage cancers an operable condition. The recurrent cancer is the most common concern in patients who undergo a breast-conserving surgery. Studies have demonstrated that there is no difference between the patients, who undergo mastectomy – the removal of the entire breast-, and the patients, who undergo breast-conserving surgery, in terms of survival. Another important issue is the requirement of radiotherapy in most patients who undergo breast-conserving surgery. Addition of this treatment reduces the risk of recurrence.
What is oncoplastic surgery?
Oncoplastic surgery is a therapeutic technique that helps ever increasing number of patients who benefit from breast-conserving treatment in breast tumors. Although large breast tissue areas are removed with plastic surgery techniques, the breast is recontoured and the other breast is corrected to ensure symmetry and thus, not only the cancer is definitely cured, but also better aesthetic outcomes are obtained.
What is mastectomy?
Mastectomy implies surgical removal of all breast tissue. This method is a surgical option for patients who are not suitable for breast-conserving surgery. Mastectomy is a surgical method that is preferred for certain types of cancers, large tumors, patients who received radiotherapy for breast and for specific patient-related factors. There are various techniques. Breast reconstructions can be carried out using implants during the surgery or simultaneously with the surgery using the patient’s own tissues or in a future period after the surgery. Risk-reducing mastectomy can also be performed for both breasts of patients who have genetic predisposition to cancer or who have genetic mutations detected before cancer develops.
What are the surgical methods for lymph nodes in breast cancer?
Lymphatic circulation of the breast is largely towards axillary (armpit) lymph nodes. Whether there is a spread of tumor in axillary lymph nodes is crucial in staging and treatment of breast cancer. In the past, axillary lymph nodes were largely removed during the surgery as a standard approach for all patients, while lymph nodes can mostly be protected thanks to novel treatment options today. This procedure can be performed as a part of breast cancer surgery in the same session for patients with surgical diagnosis regarding lymph nodes while it may be performed in a second surgery for some cases. There are two main types of surgery for lymph nodes:
What is sentinel lymph node biopsy (SLNB)?
Sentinel lymph node biopsy is performed using special stains or nuclear medicine techniques and the aim is to detect the lymph nodes where the lymph circulation from the breast reaches first and to evaluate whether there are cancer cells in those lymph nodes. For the patients with no suspicion of spread in axillary lymph nodes in preoperative examination and imaging tests, pathological examination of 1 to 3 lymph nodes detected with the mentioned methods is made and if spread is not observed, an extensive surgery is performed for the remaining area. Therefore, potential side effects of an extensive surgery in axillary region, such as pain, limited movements and edema in arm, are substantially avoided. This method can be employed for patients with advanced stage tumor who show complete response to chemotherapy.
What is axillary lymph node dissection (ALND)?
Axillary lymph node dissection is a surgery performed for patients with spread in axillary region and the aim is to substantially remove the lymph nodes in this region; however this method is less needed today.
What is breast reconstruction during or after mastectomy?
The breast can be reconstructed following breast conserving surgeries or mastectomy either simultaneously or in the future. To that end, breasts are reconstructed with prosthetic materials or the patient’s own tissues.
As is the case for most of the diseases, the way to obtain successful results in treatment of endocrine disorders is to diagnose the condition early. For early diagnosis of those diseases symptoms of which are mostly neglected, it is critical to have regular follow-up examinations at Endocrinology and Endocrine Surgery departments. Major developments have been achieved in the field of endocrine surgery in recent years and the field has an important role in treatment of endocrine disorders.
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