For Malignancy


The most modern oncoloplastic techniques are applied so that there is an excellent oncological but at the same time aesthetic result. The end result is that the operated breast has a small scar to the point where it will not be seen in the future and is in absolute symmetry with the other breast. In this case, only the lesion is removed, preserving the rest of the breast, leaving healthy margins in the breast. After the oncectomy the woman must undergo radiation therapy.

R.O.L.L. METHOD (Radioguided Occult Lesion Localisation) FOR THE LOCATION OF CANCER

It is an innovative method used by Dr. Ioanna Galanou for detecting non-palpable breast cancer (usually a few millimeters). With this technique, Tc99 technetium is injected into the tumor. In this way, in the operating room, the damage is detected with great precision without removing more healthy tissue, having healthy resection margins and at the same time an excellent aesthetic result. This technique is performed in a specialized breast center in collaboration with the nuclear medicine department.

( Intraoperative Radiotherapy ) DURING THE SURGERY

An oncectomy and simultaneous radiation therapy around the oncectomy area is performed with a robot, without the patient undergoing 1 month of radiation therapy. Unfortunately, this radiotherapy robot does not exist in Greece. Dr. Galanou handles it in Rome, at the European Oncology Center I.FO. He has specialized in the most modern model at the European Oncology Center I.E.O in Milan and at the Clinica Universidad De Navarra Oncology Center in Madrid and hopes that the specific technique will soon to be implemented in our country.


It is done when the cancer is multicentric, i.e. in different parts of the breast and not in the same quadrant. There are many modern techniques that give a very good oncological and aesthetic result while preserving the areola and nipple, as long as a rapid biopsy is done behind the nipple during surgery. Dr. Galanou uses the most modern surgical techniques that she also applies at the European Oncology and Research Center Regina Elena in Rome to offer the woman a perfect oncological and also aesthetic result.


In this surgery, mastectomy and reconstruction are performed at the same time without the need for a second surgery. This advanced surgical technique is performed using certified premium quality implants with or without mesh. In this case, a quick biopsy is done in the operating room behind the nipple to make sure there is no cancer. In the same surgical time, a procedure is also performed on the other breast in order to ensure symmetry and also obtain a very good aesthetic result.


This surgery is performed on small or medium-sized breasts with preservation of the areola and nipple, placing a tissue expander or a permanent implant. In the case of permanent implant placement, the surgery is done at the same time, avoiding a second procedure. In this case, a quick biopsy is done behind the nipple to make sure there is no cancer in that area. The choice of technique depends on the woman’s body type.


It is the mastectomy performed in case BRCA1/BRCA2 gene mutations are found. Prophylactic mastectomy is the only method that can significantly reduce the risk of breast cancer. It is estimated that prophylactic mastectomy can reduce the risk of breast cancer by 90-100% if the surgery is performed by a specialized breast surgeon with total removal of the mammary gland.

The surgeries that can be performed are skin sparing or nipple sparing mastectomy with immediate reconstruction in the same surgery or with the use of tissue expanders. A sentinel lymph node biopsy is not performed in prophylactic mastectomy.


Breast reconstruction with autologous tissues (flaps) after mastectomy is done without the use of implants, but by ‘transferring’ the tissues of the same patient from various parts of the body to the breast. Flaps can be stalked or free vascularized. In the free flaps, with the help of a microscope, the vessels of the donor area (e.g. the abdominal area, buttock) are anastomosed and sutured with the recipient area of ​​the breast, in the internal mammary or thoracic vessels.

There are many autologous tissue repair techniques such as:

TRAM (transverse rectus abdominis flap)

Latissimus dorsi from the dorsal region

DIEP (deep inferior epigastric artery perforator flap)

SIEP (superficial inferior epigastric artery flap)

IGAP (inferior gluteal artery flap)

TUG (transverse upper gracilis flap)

The disadvantage of this operation is the long operation (6-7 hours).


The sentinel lymph node in breast cancer is the first lymph node to receive lymph from the affected area of ​​the breast and the first cancer cells, when they are detached from the tumor.

The techniques used by Dr. Galanou are the following:

  • Radioisotope complexes such as Tc99m with colloidal substances. This procedure is done in the nuclear medicine department on the same day of surgery or in the afternoon of the previous day. The search for the sentinel lymph node is done in the operating room with a portable γ radiation detector.
  • Use of Indocyanine (indocyanine Green – ICG) with the method of fluorescence (Fluorescence). The sentinel lymph node is located using a special camera.
  • Sentimag. Sentimag uses a magnetometer connected to a special γ probe and a magnetic tracer consisting of 60 nm paramagnetic iron oxide nanoparticles (SIENNA+). They are CE certified. Dr. Galanou is one of the first surgeons in Europe to use this technique on many of her breast cancer patients at the Regina Elena IFO European Oncology Center in Rome, with excellent results. Dr. Galanou published this pioneering technique in a scientific article in one of the best international medical journals.
    Her goal is to be able to apply this technology in her home country as well.
    Eur J Cancer Care (Eng) 2017 Jul,26(4).doi10.1111/ecc.12385.Epub2015 Sep 14.
    The superparamagnetic iron oxide tracer: a valid alternative in sentinel node biopsy for breast cancer treatment.
    Carretta E2, Di Filippo F3 , Battaglia C4, Fustaino L1,  Galanou I3, Di Filippo S3, Rucci P2, Fantini MP2, Roncella M1.
    Author information
    1. Breast Cancer Center, University Hospital of Pisa, Pisa, Italy.
    2. Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.
    3. Department of General and Breast Surgery, Regina Elena National Tumor Institute, Roma, Italy.
    4. Breast Surgery, Sanremo Civic Hospital, Sanremo, Italy.
  • Blue dyes such as isosulfan blue, patent blue V and blue de methylene
    SNOLL (modified sentinel node and occult lesion localization technique)

S.N.O.L.L (modified sentinel node and occult lesion localization technique)

It is done by injecting an isotope (nanocolloidal radiotracer) in cases where we have non-palpable tumors. With the same method, we locate the non-palpable tumor and the sentinel lymph node at the same time.


It is the removal of the lymph nodes of the axillary cavity when the biopsy of the sentinel lymph node is positive for metastasis or when preoperatively we have infiltrated lymph nodes. A drainage tube is placed during surgery for a few days.