SURGICAL OPTIONS
My point of view in breast cancer surgery is to improve breast aesthetics, preserve as much as possible of the non-metastatic axillary lymphatics, and improve the quality of life in addition to obtaining the cancer cure.
There are two main components of breast cancer surgery:
– breast tissue surgery
– axillary surgery
Patients frequently face to multiple (more than one) surgical options after breast cancer diagnosis. Sometimes the surgical options can be changed surgeon to surgeon depanding on their preference. On the other hand, Patients often think that a total mastectomy will protect against cancer more effectively. But this may not a correct judgment. It can be applied in certain situations, but not in all cases. Please reconsider your decision to have a total mastectomy or demanding of new breast if you have cancer diagnosis.
YOU SHOULD LET YOUR SURGEON KNOW IF YOU WANT AESTHETICALLY PLEASING BREAST OR IF YOU DONT WANT TO LOSE YOUR BREAST AT ALL
In general, radiotherapy is almost always necessary after surgery when the breast is preserved (breast conserving surgery) and only the cancer area is removed. This practice remarkably reduces breast cancer recurrence rates.
The removal of small tumors does not cause severe deformity in the breast, but removing more than 20% of tissue and repeated surgical procedures can significantly impair the aesthetics of the breast. While removing cancer focuses in the breast, breast re-shaping procedures vary from surgeon to surgery. There are about 200 methods to replace the tumor in the breast tissue. For example, in a patient with large breasts, a tumor can be removed by reducing the breast. In other non-tumor breast, it decreases at the same rate, and decrease when the treatment of the tumor breast is completed. A tumor is removed in a patient with mastopexy and can be applied bilaterally.
In certain cases (strong family history about breast cancer, multi-focus breast tumor, etc.) both breasts can be removed by preserving nipple and breast skin and remedied by silicone implants immediately. Many patients can get rid of post-surgical radiation therapy after this kind of surgery.
Human right to have second opinion. I suggest you consult at least two surgeons.
AXILLARY LYMPH NODE SURGERY
The preservation of the axillary is of utmost importance. Complete axillary dissection is frequently indicated more than 2 sentinel lymph node metastasis and radiologically/clinically confirmed cancer spread to axilla and in-complete axillary response after chemotherapy. This procedure can cause persistant arm edema and arm-movement problems depending on removed lymph nodes. However this problem can also develop as a result of radiation therapy in the axilla.
The sentinal lymph node is the first regional lymphatic node that the tumor reaches. Negativity of sentinel nodes means that there is no spread in other nodes. Thus, the patient is protected from large-scale lymph surgery, which has more side effects ie arm edema and shoulder disfunctions.
This node is commonly detected in two ways:
a) The blue dye method is a special paint called lymphosurine, which is applied to the breast immediately before surgery. During surgery, the blue-coloured lymph nodes are sampled surgically. It has a few side effects, though. For example, an allergy may develop. A few days, you can see the blue-green urination
b) Radioactive method: A special radioactive substance is injected into the breast a few hours before surgery. In surgery, an active lymph node is detected and examined using a special probe. This method is extremely safe and effective (I personally prefer it to almost all patients)