In cases diagnosed with breast cancer, treatment options vary depending on the clinical stage of the patient. Physical examination and imaging tests reveal tumor size and distribution to the underarm lymph nodes. Following this, the spread to distant organs is examined. The first option for tumors confined to the breast is usually surgery. If the tumor diameter is 5cm or more, the chemotherapy option should be considered first, even if it has not spread outside the breast.
Clinical staging of the tumor is done only to review treatment options. Final staging should always be done according to the pathology result. Two types of surgery can be performed on patients who are suitable for surgery as a result of clinical staging. The first option is breast-conserving surgery. In this option, a part of the breast is removed and the tumor is removed. With the oncoplastic technique, symmetry of the breast with the other breast is achieved in terms of shape and size. The second option is the removal of the entire breast (Mastectomy) in patients who are not suitable for breast-conserving surgery due to breast volume and tumor size ratio. In suitable cases where we perform this surgery, the inside of the breast can be emptied and a silicone implant (prosthesis) can be placed in the same session. Thus, a more aesthetically acceptable operation can be performed in a single session. In cases that are not suitable for this, aesthetics can be achieved by filling the breast with its own tissue.
In both breast conservation and mastectomy options, the underarm lymph node status is evaluated simultaneously. If lymph node spread is detected by imaging and physical examination, the underarm lymph nodes should be cleaned. In cases where there is no obvious lymph node involvement, lymphatic involvement is investigated during the operation. This practice, performed at the beginning of the operation, is called "sentinel lymph node sampling". Sampled lymph nodes are sent for rapid pathological examination (Frozen examination). Depending on the result, the under arm operation is shaped. In cases where tumoral spread is detected, the underarm lymph nodes are cleaned in the same session. If no tumor involvement is detected, the armpit is closed. The operation continues with the breast.
After the surgical treatment is completed, the final staging of the patient is made based on the pathology result. Other treatments are planned in the council with Medical Oncology and Radiation Oncology.
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