The operation constitutes the first step of the treatment. The aim of surgery is to completely remove the cancer from the breast.
Breast Conserving Surgery
The surgeon will try that only the malignant nodes removed from the breast with a certain safety margin. This is now possible in about two-thirds of the cases, since many nodes are detected in time. However, if cancer exceed a certain size or spread in several places in the breast, then entire breast must be removed. Such surgery is medically referred to as retinal detachment or as mastectomy.
For the further course of the disease, it is very important to know whether breast cancer cells have penetrated into the lymphatic system or not. If penetrated than usually during surgery lymph nodes are removed from the armpit and examined microscopically for tumor cells. A novel method is the “Sentinel Technique”: Initially, only the so-called sentinel lymph nodes is removed and examined microscopically.
The Sentinel is the first lymph node in the chain of axillary lymph nodes. If cancerous cells are present, it can be dispensed with the complete removal of the armpit, which brings additional benefits for women. This method is currently no standard method and is still under review in clinical trials.
Criteria for breast-conserving surgery
- The node is still relatively small, that is, no larger than 2-3 cm (is still somewhat dependent on the size of the breast).
- The node must have a sufficiently large distance from the nipple.
- The node must not be ignited.
- The node has no spur in the surrounding milk ducts.
- The node has to start from the gland ducts, not of the lobules.
After a breast-conserving surgery radiotherapy of the operated breast must be made to minimize the risk of recurrence of the cancer as possible. In addition, usually there is a drug therapy – either in the form of short-term chemotherapy or hormone therapy for an extended period.
Sometimes treatment is started with chemotherapy or radiation instead of surgery to shrink a large tumor, to make breast-conserving surgery possible.
Inmastectomy the breast is removed (or tumor tissues are removed as much as poosible ). In most cases, it is possibility that lymph nodes are also removed under the arm. After surgery, radiation therapy can be performed……
Criteria for a mastectomy
The doctor will advise mastectomy, if the risk of recurrence of the cancer is too high. Because the recurrence increases the risk that the cancer has more offshoots (metastases) formed in the body, which drastically deteriorates the chance of recovery.
When Mastectomy is inevitable?
- The node has exceeded a certain size (about 3-4 cm) or spread in several places in the breast.
- The node is inflamed.
- The node is close to the nipple or deducts these already.
- The cancer has broken through to the outside and has an ulcer formed.
- The cancer has offshoots in the milk ducts.
- The node has come back after breast-conserving surgery and radiation.
- When radiotherapy is rejected after breast-conserving surgery.