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Breast-conserving surgery implies removal of the breast cancer zone ...
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Recently, it is ever increasingly performed and successful results are obtained.
Breast Reconstruction After Mastectomy
Promising results are gained based on the advanced technology in early diagnosis and treatment of breast cancer that is among most common cancers in women. Based on these advancements, “simultaneous mastectomy and breast reconstruction” – one of most significant procedures in the field of oncoplastic surgery- is, recently, is ever increasingly and successfully performed. Breast reconstruction surgeries minimize effects of breast losses – with extremely negative psychosocial and sexual effects on many women - secondary to breast cancer. Assoc. Prof. Gökan Adanalı, M.D., from Plastic, Reconstructive and Aesthetic Surgery Department of Güven Health Group, informs about the practice of breast reconstruction surgeries that are carried out in combination with or after mastectomy.
Type of breast reconstruction is determined according to type and stage of cancer.
Mastectomy is the principal surgical treatment of breast cancer and it implies surgical removal of breast tissue. Recently, “post-mastectomy breast reconstruction (mastoplasty)” is the principal component of modern oncoplastic surgery and it aims conserving both breasts of the patient after the operation; if the breast is partially or completely removed due to cancer, the breast is reconstructed using synthetic materials, also called implant, or native tissues of the patient. In some cases, synthetic materials and muscle or musculocutaneous tissues are used in combination. Although this method was reserved for certain types of breast cancers and carefully selected patients in the past, advanced technology enabled surgeons to employ this method in almost all breast cancer cases.
Breast reconstruction surgery is planned according to type and stage of breast cancer and the extent of cancer. For example, if mastectomy offers complete cure for a patient with early stage breast cancer, breast reconstruction surgery can simultaneously be planned. Another way is followed for patients with risk of recurrence.
Breast reconstruction is performed in two different ways.
The procedure is performed in two different ways depending on whether native tissue of the patient or silicone materials, also called implant, are used to reconstruct the breast. In some cases, both native tissue of the patient and silicone materials are used in combination. Recently, breast implants are used in every seventy six of one hundred breast reconstructions in the United States. If native tissues of the patient are used, abdominal tissues are most commonly used for breast reconstruction surgeries. In addition, dorsal muscle tissues can also be used to reconstruct breasts.
Some cases require mammoplasty also for the healthy breast.
One or both breasts can be reconstructed depending on the size and sagging of breasts. If the healthy breast is sagging, it may be necessary to reconstruct the healthy breasts in order to ensure optimal symmetry. In such cases, after the breast with cancer is repaired and optimal breast configuration is obtained, the healthy breast is operated on to make it look similar to the optimal breast.
Prosthesis does not hinder post-mastectomy treatment
Breast is one of the building blocks for self-confidence in women and removal of breasts causes negative psychosocial effects in many women. Oncoplastic surgery should reconstruct a breast that looks very similar to normal breast tissue in order to keep the patient motivated throughout the anti-cancer treatment. Breast reconstruction does not hinder the treatment after the mastectomy. Chemotherapy can be administered or radiotherapy can be maintained in the presence of prosthesis. Since major advancements are made in imaging methods, breast implants do not lower quality of follow-up imaging studies. In anti-cancer treatment, one tip of the success is to keep the patient motivated. Oncoplasticc surgery means both anti-cancer treatment and reconstruction of the organ that is lost due to cancer. Therefore, this surgical method not only cures the treatment, but it also provides the patient with moral support.
Breast repair should be carried out by an experienced team in an equipped facility.
For breast repair/reconstruction after mastectomy, the general surgeon who removes the breast should follow the principles of oncoplastic surgery. Research demonstrates that the previous surgical method, which aimed to remove the cancer by resecting the entire breast, actually has no advantage. Instead, more successful outcomes are obtained in surgeries, wherein breast tissue is completely removed, but skin tissue is conserved to enable reconstruction afterwards. Mastectomy and the subsequent breast reconstruction surgeries should be performed in a fully-equipped facility with necessary technological infrastructure by a team of general surgeon, plastic surgeon, radiation oncologist, medical oncologist, radiologist and psychiatrist.
Breast cancer, which is an extremely common and crucial disease, can be seen in one of every eight women. Developing imaging methods help the early diagnosis of this disease. Currently, advanced stage breast cancer cases are almost never seen. If breast cancer is diagnosed at early stage, it can be successfully treated and both breasts can be conserved at higher rates relative to the past experiences. Therefore, one should worry about being late rather than having this disease. Women should not neglect regular breast examinations and have mammography and breast ultrasounds at appropriate intervals.
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