Does EVERY PATIENT WITH BREAST CANCER HAVE BREAST REMOVAL REQUIRED?
The types of surgical methods that play an important role in the complete disappearance of the disease vary according to the stage or course of the cancer. When surgery comes to the fore, almost every woman asks the question of whether or not her breast will be removed. However, the primary aim of surgery today is to completely remove the tumor and protect the breast. Mastectomy, which is the removal of the entire breast, is performed in special cases and if the patient wishes. Since breast-conserving surgery is not suitable for patients with large size of the tumor, small breast, or with tumors in more than one area of the breast, mastectomy is performed. The primary treatment is surgery. However, in inflammatory type breast cancer and locally advanced breast cancer, surgical treatment is applied first after chemotherapy. When the tumor is large in diameter, if a direct surgical intervention is performed, it is necessary to remove the entire breast. First of all, it is possible to protect the breast by reducing the diameter of the tumor with chemotherapy. Surgical treatment is also not performed in breast cancers with distant spread, except in selected cases.
WHAT IS BREAST PROTECTIVE SURGERY?
In this method, the part of the breast containing the tumor is removed instead of the entire breast. The tumor tissue is removed along with some healthy breast tissue around it, and the rest of the breast is preserved. This procedure is called “lumpectomy”. In the "cadrenectomy" procedure, in which the tumor is removed with slightly wider margins, the quarter of the breast where the tumor is located is removed. Radiation therapy is given to the breast to protect the remaining breast after surgical treatment.
WHAT IS PROTECTIVE MASTECTOMY?
Prophylactic mastectomy is the removal of one or both breasts to reduce the risk of developing breast cancer.
Removal of both breasts as a preventive treatment in women with BRCA1 or BRCA2 gene mutations who express a high risk for breast cancer can reduce the risk of developing breast cancer by 95%. In women with a strong family history of breast cancer, preventive mastectomy can reduce the risk of developing breast cancer by 90%.
If there is a high risk, a protective mastectomy can be performed on the healthy breast. In these patients, a new breast can be made by placing a prosthesis in the same session.
WHAT IS SENTINEL LYMPH GLAND BIOPSY?
Breast cancer can spread to axillary lymph nodes. Previously, all of the axillary lymph nodes were removed to determine the stage of the disease in breast cancer and to determine whether there was involvement in the lymph nodes. However, in many patients, axillary lymph node involvement was not detected, and this procedure was performed unnecessarily. In addition, depending on the procedure, problems such as swelling, numbness, loss of movement, and weakness in the arm could develop. Today, especially in early stage cancers, "sentinel lymph node biopsy", which is the process of finding and removing the first lymph node from which the tumor will spread, is performed in order not to remove the underarm lymph nodes unnecessarily. In this technique, blue dye and/or radioactive material is injected into the breast where the tumor is located before the surgery. Thus, the first lymph node or glands to be affected by the disease are found and removed during the operation. With the rapid pathological examination performed during the surgery, it can be determined whether the disease has spread to the lymph nodes, and if there is, other glands are also removed.
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