ONCECTOMY WITH THE MOST MODERN ONCOPLASTIC TECHNIQUES
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.
ONCECTOMY AND INTRAOPERATIVE RADIOTHERAPY I.O.RT
( 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.
AREOLA AND NIPPLE PRESERVING MASTECTOMY WITH IMMEDIATE RECONSTRUCTION IN THE SAME SURGERY
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.
NIPPLE SPARING MASTECTOMY
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.
BILATERAL MASTECTOMY WITH BREAST RECONSTRUCTION
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
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).
SENTINEL LYMPH NODE BIOPSY USING ADVANCED TECHNIQUES
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:
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.
ARMPIT LYMPH NODE CLEANING
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.