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El breast cancer It is one of the most frequent malignant gynecological pathologies and it is usual that a surgical intervention must be performed. That is why our specialists want to explain in detail the most important aspects of the breast cancer surgery.

INCIDENCE AND CURE RATES OF BREAST CANCER

In Spain, around 33.000 new cases of breast cancer are diagnosed each year, and it is estimated that 1 in 8 women will develop breast cancer in her lifetime.

The cure rate for breast cancers currently reaches 90% and is very close to 100% in the early stages, thanks, among other factors, to the fact that the cancer is detected in very early stages during preventive check-ups or in scheduled check-ups when there are recent symptoms.

Risk factors for breast cancer

  • Two close relatives have suffered from breast cancer.
  • A male relative has suffered from breast cancer.
  • A relative diagnosed before the age of 35.
  • Consuming alcohol, smoking, not practicing physical activity or maintaining a high fat intake.

Most common symptoms of breast cancer

  • A lump in the breast or armpit.
  • Swelling, hardening, or change in the shape of the breast.
  • Spontaneous secretions from the nipple.
  • Retraction of a nipple.
  • Thickening of the skin of the breast.
  • Pain in any part of the breast.

STEP BY STEP: FROM DIAGNOSIS TO SURGICAL INTERVENTION

After mammography or breast ultrasound, if the radiologist indicates that there is suspicion of cancer, a study is started to confirm or rule out the suspicion.

  • Radiologists perform a needle biopsy (under local anesthesia and on an outpatient basis) to obtain a tissue sample from the suspicious area.
  • Pathologists analyze the sample and rule out or confirm whether it is breast cancer.

If the breast cancer, Women's team of specialists meets, completes the diagnosis and agrees on a personalized treatment plan according to the characteristics of the tumor.

In some cases, it is advisable to perform chemotherapy before carrying out the surgical intervention. This is followed frequently by conservative treatment, with only the tumor and the sentinel node removed.

In early stages of breast cancer, intraoperative radiation therapy can be performed during the intervention. Thus, with just 30 minutes more, the patient is spared daily post-surgery external radiotherapy sessions.

Only occasionally is it necessary to perform a mastectomy (removal of the mammary gland or part of it). In this case, immediate breast reconstruction is planned so that the patient, upon waking from the operating room, maintains her anatomical integrity.

Throughout the process, the professionals involved in the treatment remain available to the patient to satisfy their doubts, attend to their needs and provide them with the most adequate and constant support.

HOW TO PREPARE FOR THE INTERVENTION

It is necessary for the patient to inform her surgeon about the medications, nutritional supplements or natural remedies that she may be taking, so that the specialist can indicate whether or not she should stop taking them in the days prior to the intervention.

It is recommended that the patient reduce the pace of life and stress in the days prior to the intervention, do not consume tobacco (because it can hinder postoperative recovery), do not drink alcohol during the 48 hours prior to the intervention and follow the indications of your gynecologist to maintain a bland diet.

  • No Smoking
  • Not to drink alcohol
  • Maintain a bland diet
  • Decrease stress

HOW IS THE HOSPITALIZATION PROCESS

On the day of the surgery it is important that the patient comes accompanied.

Once admitted to the ward, the patient is informed about the approximate time of the intervention and, before entering the operating room, the medication prescribed by the anesthetist is administered.

Once the surgery is finished, the patient goes to the resuscitation area until she is discharged to the ward, where the patient is explained what she can do, when she can drink, feed, get up or receive visits.

In case the patient feels pain, she should report it to the nursing staff.

INTRAOPERATIVE RADIOTHERAPY

Intraoperative Radiation Therapy (IOR) is used in the treatment of different tumors, but it is especially suitable in the treatment of breast cancer when the tumor is small.

It is a technique that allows radiation therapy to be administered while the patient is in the operating room and the surgical intervention is being carried out in which the tumor is removed.

  • It is possible to very precisely visualize the area to be irradiated.
  • The tumor cells are completely removed.
  • Damage to healthy tissues is avoided.
  • The duration of treatments is reduced.
  • Quicker recovery is achieved.

In a single surgical act, it is possible to remove the tumor, administer radiotherapy, reconstruct the breast and avoid external radiotherapy sessions after the intervention.

TYPES OF BREAST CANCER SURGERY

The goal of breast cancer surgery is to remove all cancer cells from the breast.

The size and stage of the cancer are some of the factors that can determine the most appropriate type of surgical intervention.

  • Lumpectomy (breast-conserving surgery)
  • Mastectomy
  • Risk reduction mastectomy
  • Reconstructive breast surgery
  • Sentinel node biopsy

TUMORECTOMY (BREAST CONSERVATIVE SURGERY)

Lumpectomy or breast-conserving surgery is a surgical procedure in which the tumor, a small amount of the healthy tissue that surrounds it, and the sentinel node are removed, but the breast is preserved.

The possibility of breast-conserving surgery depends on factors such as the size of the tumor, its location, and the wishes of the patient.

Generally, breast-conserving surgery requires the administration of radiation therapy, in order to eliminate the tumor cells that may remain.

  • Post-surgery recovery time: generally, between 5 and 10 days of relative rest.

MASTECTOMY

Mastectomy is a surgical procedure in which all or part of one or both breasts is removed.

The performance of the mastectomy depends on factors such as the size of the tumor, its location and the wishes of the patient.

Whenever possible, immediate reconstruction of the breast is planned so that the patient, at the end of the intervention, maintains her anatomical integrity.

  • Post-surgery recovery time: generally between 2 and 4 days of hospitalization and between 6 and 8 weeks of relative rest.

RISK REDUCTION MASTECTOMY

Risk-reducing mastectomy is a surgical procedure that involves removing one or both breasts in women who have not developed cancer, but are at high risk of developing it.

Mastectomy is a preventive surgery that significantly reduces the chances of developing breast cancer, but does not completely eliminate the possibility of developing it in the future.

  • Post-surgery recovery time: generally between 2 and 4 days of hospitalization and between 6 and 8 weeks of relative rest.

RECONSTRUCTIVE SURGERY OF THE BREAST

Breast reconstruction surgery is performed with the goal of recreating the natural shape of the breast after a mastectomy, so that the breast or breasts appear similar to what they did before surgery.

On many occasions, breast reconstruction can be carried out in the same surgical act in which the breast is removed, so that the patient, after the intervention, maintains its anatomical integrity.

But if necessary, it is also possible to perform breast reconstruction surgery later, when the patient has completed the treatment indicated by her gynecologist.

SENTINEL GANGLION BIOPSY

The sentinel node is the lymph node where cancer cells are most likely to spread.

Sentinel node biopsy is a surgical procedure that involves finding the node, removing it, and testing it to find out if cancer has spread to the lymphatic system.

RISKS AND SIDE EFFECTS

Breast cancer surgery is a safe procedure that usually has few complications or side effects during or after surgery.

The side effects produced by the surgical intervention depend on the type of intervention and the profile of each patient.

The most common side effects are pain or numbness in the area where the surgery was performed, reactions to local anesthesia, bleeding, and the possibility of infection.

CONTROLS AND MONITORING OF BREAST CANCER

Generally, the reviews include a medical history, complete physical examination, blood tests with determination of tumor markers, annual mammography and other tests that may be considered necessary to verify that the disease does not recur.

Once the treatment has been completed, during the first two years it is advisable to perform periodic gynecological examinations every three or four months.

  • First 2 years: gynecological check-ups every 3 to 4 months.

After the first two years, the reviews and controls are generally carried out every four to six months up to five years and, from then on, the reviews must be done at least annually.

  • Between the 2 and the 5 years: gynecological check-ups every 4 to 6 months
  • From the 5 years: gynecological check-ups every 12 months.

If the patient feels discomfort or thinks she has any symptoms, it is necessary that she go to her gynecologist's office as soon as possible to do the medical tests that allow a safe diagnosis to be reached and, if necessary, start the appropriate treatment as soon as possible.

PREVENTION OF BREAST CANCER

The age of inclusion in the Breast Cancer Early Detection Program depends on each autonomous community: in most cases, women who are in the age group considered to be at greatest risk (between 50 and 69 years ) can participate every two years.

Thanks to the mammography tumors can be seen before they have invaded breast tissue, distant organs, or lymph nodes. In this way, breast cancer can be identified in its earliest stage (up to 2 years before it becomes palpable) and an early diagnosis that can save lives can be achieved.

En Women's CD Gynecological ClinicWe recommend that our patients start to undergo an annual mammogram in conjunction with the revision, even if they do not have symptoms, starting at the age of 40, even if they do not have symptoms. And if there is a high risk of cancer due to a family history of breast or ovarian cancer, we recommend that mammography begin at the age of 30.

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