Breast cancer: surgery
A breast cancer tumor is always surgically removed if possible. If possible, the doctors choose a breast conserving therapy (BET). In some cases, however, the entire breast must be amputated ( mastectomy ).
Breast conserving therapy (BET)
In breast-conserving therapy, the tumor is removed, while the breast itself is (largely) preserved. This is possible with many patients. However, certain conditions must be met . For example, breast conserving surgery can only be performed if the tumor is localized. In addition, in relation to the breast, it should not be too large and should not grow multicentrically (ie not consist of several foci in different quadrants of the breast).
Along with the cancerous tumor, a marginal area of healthy tissue is removed during breast conserving surgery . This is to make sure that no marginal cancer cells remain in the body. The immediately adjacent lymph nodes (sentinel nodes) are excised. During the procedure, they are examined under a microscope to see if they are already affected by cancer cells. If so, the surgeon must also excise lymph nodes from the armpit.
Note: After breast-conserving surgery, radiotherapy usually adjoins (adjuvant radiation).
In some breast cancer patients, the tumor is too big for breast-conserving surgery. Then the entire diseased chest must be removed. The procedure is called mastectomy . It may also be necessary for other reasons, such as when the tumor consists of several cancers in different quadrants of the breast or is an inflammatory breast carcinoma.
The mastectomy can be performed in different variants. Previously, along with the entire mammary tissue, the overlying skin and the nipple and the chest muscles was removed. Today, one usually uses gentler techniques that preserve the pectoral muscle. Sometimes you can even leave the breast skin and the nipple. The doctor will discuss with the patient the most appropriate op variant in advance.
Read more about the course and risks of a mastectomy in the article Mastectomy .
A mastectomy is often followed by breast reconstruction . The removed breast is rebuilt with an implant or own tissue. Even after breast conserving surgery, breast augmentation may be useful if the surgeon had to excise a great deal of tissue from the breast during tumor removal.
In both cases: A breast buildup after a breast cancer op is not a plastic surgery out of vanity! Especially after a mastectomy many women feel “incomplete” and less feminine than before. Even a breast-conserving surgery can be mentally distressing if the two breasts look very different afterwards. Breast reconstruction can help those affected to feel better in and with their bodies. This is important for the healing process!
In addition, especially the complete removal of a breast can cause postural damage and back pain . So there are also medical reasons for breast augmentation. Breast cancer patients should therefore not be afraid to consult their doctor to discuss the possibilities of breast reconstruction in detail!
Sometimes breast augmentation is not possible after mastectomy, or the patient decides against it. Then the absence of a breast can be masked with a breast prosthesis ( breast pithesis). There are several models available:
The simplest variant is an insert made of foam or silicone. She is pushed into the bra to visually replace the missing breast. In medical supply you get special prosthesis bras with incorporated pockets for the deposits. Also special swimsuits and bikinis with such bags are available.
Another variant is self-adhesive prostheses . They are worn directly on the skin. However, such adhesive prostheses should not be worn by women until the operation scar has healed completely and radiotherapy has been completed.