Breast Augmentation
(Breast Conservation Surgery)
For centuries, mastectomy has been considered the only way to treat breast neoplasm. By the 1980s it appeared that we could treat breast cancer in a less aggressive way. This is when breast tetartectomy, the first form of breast conservation surgery, was first introduced, with not good aesthetic results. Along with breast radiotherapy, it was shown to have equivalent oncological results to the more aggressive mastectomy. As the years went by, the scientific community understood that it was sufficient to remove the malignant tumor with minimal clean tissue around it. Today’s breast-conserving surgery is known as wide breast lumpectomy and sacrifices no more normal gland than necessary, while having excellent oncologic results.
As long as no disease is found at the resection margins during the biopsy after surgery, local surgical treatment has been successfully completed. In the rare cases where the biopsy reveals tumor as far as the resection margins, a minor resection surgery of that margin should be performed at a second time.
Directed breast lumpectomy with wire placement
If the tumor is large enough to be palpable, the surgeon performs the lumpectomy by touch. However, modern breast screening programmes aim to find tumours too small to palpate. Then, surgical removal requires identifying them to give direction to the breast surgeon. Primarily this is done by placing a guide wire under ultrasound guidance (invasive ultrasound). In the same way that a guided breast biopsy is performed, a special wire is placed in contact with the tumour. Then the lumpectomy can be performed precisely, within clear boundaries around the tumour. The section removed with the guide wire in place is then subjected to an X-ray, demonstrating the clear boundaries around the tumour.
We are pleased to inform you that at the Breast Care Clinic of Patras, the wire placement procedure can be performed during surgery, with interventional use of invasive ultrasound. The advantages of this are:
- Reduced patient discomfort, as no other procedures are required prior to surgery
- Reduced cost of the procedure compared to wire placement in a separate minor procedure prior to surgery
*In the few cases where a tumor is not palpable and cannot be seen with ultrasound, it must be identified by different methods suggested by your treating surgeon.
The need for oncoplastic surgery in breast conservation
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The issue that arose with conservative breast conservation surgery was the final aesthetic outcome. Removing a large portion of the breast with traditional tactics had poor aesthetic results. Thus, complex techniques were developed that brought together oncologic surgery with aesthetic surgery, tailored to the realm of breast cancer. It requires very specialized training, but the results are excellent for the psyche of women, who now have a high cure rate after breast cancer treatment. This set of techniques is called Breast Oncoplastic Surgery and is available to every woman at the Breast Care Clinic of Patras, even when it comes to benign breast tumors. For more details about Breast Oncoplastic Surgery, see the relevant page.
