28 Jan The Value of Preoperative Evaluation and the Selection of the Appropriate Surgical Technique
Before the surgery for breast cancer, the patient should have undergone all the appropriate tests, while the lesion should have been identified by histological examination before the day of the operation. In this way, the surgeon will be able to choose the right technique to apply for each case.
Appropriate preoperative examinations are mammography, modern breast ultrasound with elastography and in some cases magnetic resonance imaging (MRI). For pre-operative examinations it is important to choose centers that have modern technological equipment.
Depending on the results of the pre-operative tests, the surgeon will decide whether to perform a mastectomy (removing the entire gland while preserving the skin and nipple using special oncology and plastic surgery techniques) or a lumpectomy (removing a small part of the breast using oncology techniques and plastic surgery) with a sentinel lymph node, while the calculation of the dimensions and distances of the breast is also very important. By measuring the distances, the surgeon can choose the right breast implant if a mastectomy is to follow.
In lumpectomy, only part of the breast is removed when the cancer is in one quadrant of the breast. There are many surgical techniques for choosing the most appropriate one. Usually, when microcalcifications are found in the breast with a histological result of cancer in situ, most of the time the cancer is spread to all quadrants of the breast (multicentric) and therefore the right choice is mastectomy.
After the surgery, the patient needs close medical monitoring, at least for the next 5 years. The team of doctors attending the patient, the “Breast Unit”, will have to decide on the treatment or treatments the patient will undergo, such as hormone therapy, radiation therapy, chemotherapy, or a combination of some or all of these.
The patient, with the right treatment and the right choice of surgical technique to treat breast cancer, can have an extremely good life expectancy and the same life expectancy as a woman who has never had breast cancer.