Thursday, January 24, 2019

Surgical Technique For Breast Cancer


Most women with breast cancer have several types of surgery as part of their treatment. There are various types of breast surgery, and that can be done for different reasons, depending on the situation. For example, surgery can be done to:

·           Remove as much cancer as possible (breast conservation surgery or mastectomy)
·           Find out if cancer has deployed the lymph nodes under the arm (sentinel lymph node biopsy or axillary lymph node dissection)
·           Return breast shape after the cancer is removed (breast reconstruction)
·           Relieve the symptoms of advanced cancer

Your doctor can recommend certain surgeries based on your breast cancer features and your medical history, or you may have choices about what type you will have. It is essential to know your options so that you can discuss them with your doctor and make the right decision for you.

Removed breast cancer through Surgery
There are two main kinds of surgery to get rid of breast cancer:

·           Breast conservation surgery (also called lumpectomy, quadranectomy, partial mastectomy, or segmental mastectomy) - An operation where only the part of the breast containing the cancer is removed. The goal is to eliminate cancer and some healthy tissue around it. How much breast is removed depends on the size and location of the tumor and other factors?
·           Mastectomy - An operation in which the entire breast is removed, including all breast tissue and sometimes other tissues around it. There are several types of mastectomy. A double mastectomy may also get to Some women, where both breasts are removed.

Choose between breast conservation surgery and mastectomy
Many women with early cancer can choose between breast conservation surgery (BCS) and mastectomy. For the woman, The main advantage of BCS is saved most of her breasts. But in many cases, he will also need radiation. Women who have a mastectomy for early-stage cancer tend to need radiation.

For some women, a mastectomy may be a better choice, because of the type of breast cancer, large tumor size, previous treatment history, or certain other factors.

Some women may worry that less extensive surgery will increase the risk of cancer again. In most cases, the mastectomy does not give you a better chance of surviving in the long term or better results from treatment. Research conducted by thousands of women for more than 20 years shows that when BCS can be carried out simultaneously with radiation, doing a mastectomy instead does not provide a better chance of survival.

Surgery to remove the lymph nodes around it
To find out whether breast cancer has spread to the axillary lymph nodes (armpits), one or more of these lymph nodes will be removed and seen under a microscope. This is an essential part of determining the (broad) stage of cancer. Lymph nodes can be removed either as part of an operation to remove a breast cancer or as a separate operation.

The two main types of surgery for removing lymph nodes are:
·           Sentinel lymph node biopsy (SLNB) - This procedure only removes the lymph nodes under the arm which may cause cancer to spread first. Removing just one or several lymph nodes reduces the risk of side effects from surgery.
·           Axillary lymph node dissection (ALND) - This procedure removes many (usually less than 20) lymph nodes from under the arm. ALND is not done as often as before, but it may still be the best way to see lymph nodes in some situations.

Breast reconstruction after surgery
Every woman who has surgery for breast cancer can have an option for breast reconstruction. This case, a woman may want to consider rebuilding breast mounds to restore the appearance of the breast after surgery. In some breast conservation surgeries, a woman may consider doing a fat transplant on the affected breast to correct the remaining dimples from the surgery. The choice will rely on the specific situation of each woman.



There are several kinds of reconstructive surgery, although your choice may depend on your medical situation and personal preferences. You may have the choice between having breast reconstruction at the same time as breast cancer surgery (immediate reconstruction) or at another time (delayed reconstruction).

If you are thinking of reconstructive surgery, you should discuss it with a breast surgeon and plastic surgeon before your mastectomy or BCS. This treatment gives the surgical team time to plan possible treatment options that are best for you, even if you wait and undergo reconstructive surgery later.

Surgery for advanced breast cancer
Although surgery is very unlikely to cure breast cancer that has spread to other parts of the body, it can still help in some situations, either as a way to slow the spread of cancer, or to help prevent or eliminate symptoms from it. For example, operations might be used:

·           When a breast tumor causes an open wound in the breast (or chest)
·           To treat a small area of cancer spread (metastasis) in certain parts of the body, such as the brain
·           When the cancerous area spreads it compresses the spinal cord
·           To treat blockages in the liver
·           To relieve pain or other symptoms

If your doctor recommends surgery for advanced breast cancer, it's important for you to understand its purpose - whether it's trying to cure cancer or prevent or treat symptoms.

Localization of wire to guide operation
Sometimes, if cancer in your breast cannot be felt, is difficult to find, and difficult to reach, a mammogram or ultrasound can be used to put a wire in the cancer area to guide the surgeon to the right. Point. This phenomenon is called wire localization or needle localization. You might hear the term stereotactic cable localization if a mammogram is used. Rarely, MRI can be used if a mammogram or USG doesn't work.

After your breasts are numb, a mammogram or ultrasound is used to guide a thin hollow needle to an abnormal area. After the needle tip is in the right place, a thin wire was inserted through the center of the needle. A small hook at the end of the wire holds it. The needle is then taken. The surgeon uses a fence as a guide for the part of the breast to be removed.

Surgery performed as part of the wire localization may be enough to be considered a breast conservation operation if the margin is negative. If cancer cells are found on the edge of the tissue that is removed (also called a positive margin), more surgery may be needed.

It should be noted that the wire localization procedure is sometimes used to perform a surgical biopsy in a suspicious area of the breast to determine whether it is cancerous or not.
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