Surgical treatment for breast cancer varies depending on the stage of the tumor, its location and size, but the following treatment methods can generally be applied:
• Total Mastectomy (Simple Mastectomy)
• Modified Radical Mastectomy
• Breast-Conserving Surgery (Lumpectomy)
• Nipple and Skin-Sparing Mastectomy
• Skin-Sparing Mastectomy
Total Mastectomy (Simple Mastectomy): It is a surgery in which all breast tissue, breast skin, nipple and aerola (the ring-shaped colored part around the nipple) are removed. Lymph nodes are not removed in this surgery. It can sometimes be preferred in limited cases of breast cancer, especially in very elderly women.
Modified Radical Mastectomy + Axillary Curettage: This procedure, which was applied more in previous years and is applied in a limited way today, involves the entire breast tissue, breast skin, nipple and Most of the armpit lymph nodes are removed, along with the aerola.
Breast-Sparing Mastectomy (Lumpectomy): The tumor in the breast and the surrounding tissue are extensively removed. Radiotherapy must be applied after lumpectomy.
Nipple and Skin-Sparing Mastectomy: It is the current method in breast cancer surgeries. In this surgery, the nipple, aerola (red ring around the nipple) and breast skin are preserved. With special incision methods applied to the breast, only the inside is emptied and the entire breast tissue is removed. A new breast is created by placing a silicone implant in the vacated area of the breast tissue or by using the patient's own tissue, ensuring complete symmetry with the other breast.
The risk of developing breast cancer. In people with high genetic predisposition to breast cancer and gene mutations such as BRCA1,2, prophylactic (protective) mastectomy may be preferred to protect against the disease. This method is also used in breast surgery for these women.
Skin-Sparing Mastectomy: If the tumor is very close to the nipple in breast cancer, it is not possible to protect the nipple. Then only skin-sparing mastectomy can be performed. The only difference from nipple and skin-sparing mastectomy is that in this procedure, the nipple and areola are removed along with the breast tissue. Again, the breast skin is not touched and the breast is simultaneously made from silicone implants or the patient's own tissue.
What is the Situation in Breast Cancer Surgery? Should Armpit Lymph Nodes Be Removed?
Before breast cancer surgery, the armpit and surrounding lymph nodes are also evaluated simultaneously. This evaluation is made by manual examination, breast USG, mammography and, if necessary, needle biopsy of these lymph nodes. As a result of these, if there are lymph nodes of pathological size and structure, needle biopsy can be performed there. If the result is cancer spread (application varies depending on the location), either the treatment method is changed or the lymph nodes in that area are removed during the surgery. If the biopsy result is negative or no pathological lymph nodes are detected in the examination and tests, the lymph nodes are evaluated with special methods during the surgery (Lymphoscintigraphy + According to the results obtained from Gamma Counter and SLNB), it is decided to remove the lymph nodes.
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