It is not necessary to remove the breast in case of cancer
Surgical intervention plays the most important role in the treatment of cancer, especially in the early stages. Removing the entire tumor with clear surgical margins is the most effective method of treatment. In fact, it can be said that saving the patient's life depends on the adequacy of the surgical intervention.;
In the light of these correct views; For years in breast surgery, 'how much is too much'; An opinion that can be summarized as 'the better' has prevailed. In the past, removal of the breast along with the muscles in the chest wall was considered an indispensable necessity in breast cancer surgery. The lymph nodes under the armpit were removed as many as possible (approximately 30-40) and the operation was completed. As a result of these surgical interventions, there was no breast tissue left on the operated side, arm movements were damaged because the muscles that function in arm movements were removed, and since the armpit lymph nodes were removed, the lymph circulation of the arm was impaired and the arm thickness increased. Breast patients; They had to live with an edematous, swollen arm that had lost its function and increased 3-4 times its diameter.;
About 50 years ago, breast surgery research and improvements in breast surgery were carried out in both Europe and America. The 'more the better' view has been demolished. It has been proven that major surgical interventions that even end up disabling patients do not provide any benefit to patients. First, the operation to remove the chest wall muscles behind the breast was abandoned and only the entire breast was removed. Thus, operations that harmed arm movements were abandoned. Later, the operation to remove the armpit lymph nodes, which was performed regardless of whether there was cancer in the armpit or not, was abandoned and the frequency of arm swelling decreased from 30 percent to 3 percent.;
The entire breast is no longer removed, especially in single and small tumors. . Clean removal of the surgical margins of the tumor in the breast seems sufficient. Removing healthy tissues of the breast does not provide any additional benefit to the patient.;
Breast-conserving surgical interventions are performed in approximately 70 percent of women with breast cancer. However, if the tumor is very large and there is more than one tumor focus, the breast If radiotherapy has been applied to the patient for other reasons, breast-conserving surgery cannot be performed. Radiotherapy to the breast as a result of breast-conserving surgery reduces the possibility of breast cancer recurrence in the future. When breast-conserving surgery is performed, the breast must be irradiated. Irradiation of the armpit on the same side depends on whether the armpit lymph nodes are affected by cancerous cells. If the disease has spread to the armpit lymph nodes, the armpit must be irradiated in addition to the breast. While there have been significant changes in breast surgery, there have also been major changes in the preventive chemotherapy applied after the operation.;
Patients should not panic when faced with breast cancer, should not make hasty decisions, should meet with cancer specialists starting from the pre-operative period and make sure that their treatment plans are made from different specialties. I recommend that it be done by taking the opinions of physicians from their fields.
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