Breast-Related Surgeries

“Women who are aware of breast cancer and have participated in early detection programs should be rewarded with appropriate and sensitive treatment; not punished with harsh and often unacceptable treatments.”

Dr. Umberto Veronesi

(Former Italian Minister of Health, Onco-surgeon)

Former Italian Minister of Health Dr. Umberto Veronesi, the author of many groundbreaking surgical techniques and approaches to preventive breast surgery and breast oncoplasty in the treatment of breast cancer, suggested that instead of punishing "smart" women who attend routine checkups with complete removal of their breasts when they are diagnosed with breast cancer, He is a prominent surgeon who, after extensive research, has convinced medical authorities and healthcare providers that women should be rewarded with treatments that will allow them to leave the operating room with much more beautiful breasts.

In recent years, promising developments have occurred for patients who have breast cancer or who have lost or are at risk of losing their breasts due to cancer. Breast reconstruction is possible for patients in both situations.

The primary goal of modern breast surgery is to The goal is to treat breast cancer without causing breast loss.

Breast-Conserving Surgeries

• Classic Breast-Conserving Surgeries
• Macromastia and Breast Reduction

Oncoplastic breast surgery involves planning a surgical procedure for breast cancer alongside an aesthetic procedure that will create a better cosmetic result. The method combines the principles of oncologic surgery and plastic surgery. Thus; Breast reconstruction surgery is planned simultaneously for women undergoing surgery for breast cancer, while women who have previously lost a breast due to cancer are given the opportunity to regain a breast.

When discussing a treatment plan with the patient, the individual's oncological and cosmetic needs should be taken into consideration. A balanced decision should be made by considering the patient's age, medical and psychosocial status, and the woman's wishes and expectations.

Breast cancer patients die not from cancer recurrence in the breast, but from systemic recurrence (metastasis). In these cases, instead of removing the entire breast, breast-conserving surgery is preferred in appropriate cases.

This surgical method; It involves removing the tumor along with some surrounding healthy breast tissue (wide local excision, lumpectomy, quadrantectomy) and sampling the axillary lymph nodes related to the breast.

It is a frequently preferred option in the treatment of early breast cancer. It allows for the preservation of a large portion of the breast and provides a good cosmetic result. It allows the removal of the remaining breast tissue.

Radiation therapy (irradiation) must be administered to the remaining breast tissue as part of this treatment.

Situations in which Breast-Conserving Surgery Cannot Be Applied:

The patient's life expectancy between breast-conserving treatment and total breast removal There is no difference in recovery time. The advantage of breast-conserving treatment over mastectomy is the better cosmetic and psychological outcomes it provides.

If the tumor recurs in the breast treated with conservative treatment, the recommended treatment is total breast removal, i.e., mastectomy. Local tumor recurrence does not negatively impact survival.

Classic Breast-Conserving Surgery

Early diagnosis methods, increasing awareness of breast cancer in women, Learning and using breast self-examination techniques allows for early detection of the disease and the application of breast-conserving surgery.

As a result of advances in radiotherapy and chemotherapy, previously performed extensive surgeries (mastectomy) have been replaced by more breast skin (breast skin-conserving) and breast tissue (breast7Preventive surgery has been replaced by conservative surgery.

Furthermore, in cancer treatment, doctors are now focusing not only on cancer control but also on methods that aim to preserve and improve the patient's quality of life.

As with all cancers, the primary goal in breast cancer surgery is to remove the tumor tissue and save the patient's life. Unlike other cancers, the distress of breast cancer patients is not limited to the problems caused by the cancer diagnosis.

Surgical removal of the breast (mastectomy) can cause severe psychological effects in many women. After breast loss, women often experience a range of psychosocial problems, including depression and other mood disorders, loss of sexual desire, distorted body image, fear of losing feminine qualities, concerns about recurrence, difficulty finding suitable clothing, and the difficulties associated with externally applied breast implants such as bras.

Suddenly realizing that life is so close to a breaking point, coping with multiple challenges, and trying to "make life worth living" often make women more emotional and vulnerable. Voicing the problem and seeking a solution is a problem faced by husbands who do not consider their wives' psychology, an environment that perceives a woman's desire for breasts as an aesthetic problem, and a society where breasts are seen as a sexual taboo. This is becoming almost impossible due to society.

The suggestion of psychiatric support, which would enable a woman to discover what and how she wants, to know herself, and to perceive her environment more healthily, is often rejected by both her relatives and the patient herself.

Women who know, anticipate, or hear about these problems may negotiate with their physicians to avoid losing their breasts.

If the patient and the patient are both willing, the recommended type of surgery for breast loss is to remove the cancerous tissue while preserving a portion of the breast (breast-conserving surgery).

In this case, if the tumor is proportionate to the breast, If the breast is large, breast-conserving surgery may not provide the cosmetic results the patient desires. Another important point to remember is that patients must receive radiation after breast-conserving surgery. Therefore, subcutaneous or skin-sparing (removal of the entire breast, leaving the skin intact) mastectomy should be recommended for suitable patients.

Macromastia and Total Removal with Breast Reduction

In breast cancer cases in women with large breasts, it is possible to simultaneously remove both breast cancers and reduce both breasts to ideal sizes, leaving the patient happy in the operating room.

Patients undergo cancer surgery with this method and avoid the problems they experience due to large breasts (breast They are relieved of pain, back pain, shoulder pain, limited movement, persistent diaper rash under the breast, risk of spinal curvature, etc.

Until recently, giant breast disease (macromastia) was a topic addressed from an aesthetic perspective. However, the development of breast surgery and the elaboration of these issues have revealed that giant breasts are more than just an aesthetic problem; they are a functional disorder. The functional problems caused by giant breasts are often addressed through the process. We now know that it causes organic and physical problems within the body, and that there is a direct correlation between breast volume and breast cancer.

Complaints of giant breast disease should be carefully evaluated in breast clinics, cases should be taken seriously, and since the underlying problem has not been resolved, referral to physical therapy and neurology clinics or endless analgesics should not be expected to benefit.

Risk-Reducing Surgery (Prophylactic-Protective Mastectomy and Reconstruction)

Today, thanks to the advancement of genetic diagnostic methods, a full understanding of the familial inheritance of breast cancer, and the identification of genetic chromosome disorders that cause breast cancer, Revealing the possibility of breast cancer allows patients to be largely calculated.

Women with a high familial risk and genetic burden can seek ways to avoid breast cancer before it develops.

Prophylactic (protective) mastectomy has evolved due to this need. Women who are candidates for prophylactic mastectomy should first have a detailed history of all possible chromosomal abnormalities.

• Multiple tumor foci in the same breast (Multicentric tumor)
• Patients with a very large tumor or an inappropriate tumor/breast size ratio,
• Those who have previously received radiotherapy to the same body area,
• Women with connective tissue disease (because radiotherapy cannot be administered),
• Early pregnancy (because radiotherapy cannot be administered),
• Those who cannot receive radiotherapy at the appropriate time for any reason,