Surgery for Breast Cancer
Advanced Options and Personalised Care
Surgery is central to breast cancer treatment, focusing on cancer removal while preserving healthy tissue. At Breast and Wellness, we offer tailored options, including breast-conserving surgery and mastectomy, chosen based on the disease extent and patient preferences.
Breast Conservation surgery
Mastectomy
Lumpectomy
What is Lumpectomy?
A lumpectomy, or breast-conserving surgery, removes a tumour and a small margin of surrounding healthy tissue while preserving the rest of the breast. This procedure is ideal for early-stage cancers or smaller tumours and is often followed by radiation therapy to reduce recurrence risk. It balances effective cancer removal with maintaining the breast's natural appearance and functionality.
How Do Surgeons Determine the Location of a Non-Palpable Tumour During Breast Surgery?
To precisely locate and remove a tumour during breast surgery, surgeons use advanced localisation techniques. Traditionally, wire placement has been the standard method, where a thin wire is inserted into the breast on the day of surgery to mark the tumour's position. While effective, this method can sometimes cause discomfort and limit flexibility. Newer technologies, such as SCOUT localisation, offer a less invasive and more patient-friendly alternative. SCOUT uses a small reflector placed in the tumour days or weeks before surgery, which emits signals detected by a surgical probe to guide tumour removal. These technologies ensure accurate localisation, improving surgical precision and patient outcomes while reducing unnecessary removal of healthy tissue.
What are the advantages of wireless surgery compared to traditional wire-guided techniques?
Wireless surgery, such as using SCOUT localisation, offers several advantages over traditional wire-guided techniques. It eliminates the discomfort associated with wire placement and allows the localisation device to be inserted days or weeks before surgery, providing greater scheduling flexibility for patients and surgeons. Wireless systems also enhance surgical precision by emitting signals that guide the surgeon directly to the tumour, minimising the removal of healthy tissue. Additionally, it improves the patient experience by avoiding the need for wires protruding from the breast on the day of surgery, reducing anxiety and discomfort. Overall, wireless surgery ensures a more streamlined, patient-friendly, and precise approach to tumour removal.
How Does Lumpectomy Combined with Breast Reduction Benefit Patients?
Lumpectomy combined with breast reduction, also known as Therapeutic mammoplasty and adaptive mammoplasty, is a surgical approach that removes a breast tumour while reshaping and reducing the size of the breast. This technique is ideal for patients with larger breasts, as it allows for effective cancer removal while achieving better symmetry and aesthetics. Additionally, reducing the breast size can decrease complications associated with breast radiotherapy, such as skin reactions, and lower the risk of developing breast lymphedema, improving overall treatment outcomes and patient comfort.
What Are the Indications for Lumpectomy Combined with Flap Reconstruction?
Lumpectomy combined with local flap reconstruction is indicated when additional tissue is needed to restore the breast’s shape and contour after tumour removal. This technique is particularly beneficial for patients with larger tumours relative to their breast size, where a standard lumpectomy might lead to noticeable deformity. It is also ideal for individuals with smaller breasts, where removing tissue could significantly affect the breast’s aesthetics.
Patients who wish to maintain breast symmetry without undergoing surgery on the contralateral breast may also benefit from flap reconstruction. Furthermore, this approach is highly recommended for patients planning radiation therapy, as the added tissue helps preserve breast symmetry and reduces complications like skin tightening or scarring. By combining cancer removal with reconstructive techniques, this procedure provides effective oncologic treatment while enhancing cosmetic outcomes, making it an excellent option for select patients.
Mastectomy
What is a simple mastectomy?
A simple mastectomy, also known as a total mastectomy, involves the removal of all breast tissue, including the nipple, areola, and skin, while leaving the underlying chest muscles intact. Simple mastectomy is often recommended for patients with ductal carcinoma in situ (DCIS), early-stage breast cancer, or those who do not require extensive lymph node removal. It is particularly suitable for patients who do not want or are not eligible candidates for immediate reconstruction. However, delayed reconstruction remains an option to restore appearance and symmetry at a later time.
What is Nipple-sparing mastectomy?
Nipple-sparing mastectomy is a surgical procedure that removes all breast tissue while preserving the nipple, areola, and surrounding skin. Nipple-sparing mastectomy is often combined with immediate reconstruction to restore the breast’s shape and appearance, offering excellent cosmetic outcomes. Careful patient selection is essential to ensure the procedure is safe and effective, as it is not suitable for cases where cancer is located close to or within the nipple.
What is Skin-sparing mastectomy?
Skin-sparing mastectomy is a surgical technique that removes all breast tissue while preserving most of the breast skin, except for the nipple and areola, which are removed when the nipple-areola complex is involved with cancer. This approach is commonly used in cases where the skin itself is unaffected by the disease, allowing for immediate breast reconstruction. The preserved skin envelope provides a natural shape and contour for the reconstructed breast, offering both effective cancer treatment and superior cosmetic outcomes. Reconstruction of the nipple-areola complex at a later stage further enhances the result, achieving a natural and aesthetically pleasing appearance.
What is Skin-reducing mastectomy?
Skin-reducing mastectomy is a surgical procedure designed for patients with larger breasts who require both mastectomy and immediate breast reconstruction. This technique removes all breast tissue while reducing excess skin to create a tighter, more natural breast contour. It is typically performed alongside immediate reconstruction, using either implants or autologous tissue. Skin-reducing mastectomy allows for effective cancer removal while addressing issues such as breast size and symmetry, resulting in a more proportional and aesthetically pleasing outcome. In most cases, the nipple-areola complex can be preserved, but this requires more complex surgical planning to ensure safety and optimal results.
What is Goldilocks mastectomy?
Goldilocks mastectomy is a surgical technique designed for patients who undergo a mastectomy but do not wish to have traditional reconstruction with implants or autologous tissue transfer. This approach involves removing all breast tissue while preserving and reshaping the remaining skin and fat to create a natural breast contour. The term "Goldilocks" reflects the balance achieved between mastectomy and reconstruction, as it provides a moderate, natural appearance without additional surgeries or foreign materials.
This technique is particularly suitable for patients with larger breasts, as the remaining tissue can be used to form a small breast mound. While it does not fully restore the size or shape of the breast, it offers an aesthetically pleasing and proportional outcome, avoiding the need for external prostheses. Goldilocks mastectomy is a less invasive alternative that combines effective cancer treatment with a focus on simplicity and patient comfort.
Why Choose Breast and Wellness Centre?
At Breast and Wellness Centre, we offer advanced, personalised surgical care tailored to your needs. Combining expertise with compassion, we utilise state-of-the-art techniques to ensure optimal medical and aesthetic outcomes. From diagnosis to recovery, our team supports you every step of the way for the best possible results.
While our goal is to preserve the breast whenever possible, mastectomy is sometimes necessary to ensure effective cancer treatment. This procedure involves the removal of all breast tissue and is typically recommended for advanced breast cancers, multifocal tumours, large tumours in smaller breasts, or cases where breast-conserving surgery is not feasible. Mastectomy is also indicated for patients with genetic predispositions, such as BRCA mutations, or those seeking a preventative measure to reduce future cancer risk. By providing a comprehensive approach, mastectomy ensures optimal cancer control while allowing for reconstruction options to support the patient’s physical and emotional well-being.
Breast lesions can be either palpable, meaning they can be felt during a physical examination, or non-palpable, meaning they are not easily detected by touch. Palpable lesions, or those that can be identified in the office using ultrasound, typically do not require additional localisation techniques. However, for smaller, non-palpable lesions that are not easily visualised with ultrasound, a localisation technique is performed. This ensures the precise identification and removal of the lesion during surgery, improving surgical accuracy and patient outcomes.
