Breast Cancer Surgery | Dr. Mª Esther Suárez Agustín
La Dr. María Esther Suárez Agustín, gynecologist and Head of the Breast Unit of the Women's Unit at the Ruber International Hospital, offers us in This Video A detailed explanation of the surgical options available for patients diagnosed with breast cancer. It also shares how we approach different cases in the Women's Unit, tailoring treatment to each patient's individual needs.
“All patients have to undergo surgery”
Currently, all patients diagnosed with breast cancer must undergo surgery. It is essential to determine what type of surgery should be performed and when, since, in many cases, it is a primary surgeryThis means that the initial intervention is performed, followed by the complementary treatments each patient requires, such as radiotherapy, chemotherapy, or hormone therapy.
On other occasions, what is known as primary or neoadjuvant systemic therapyThis means that certain types of tumors require this treatment first before proceeding with surgery to complete the therapeutic process.
Conservative surgery and mastectomy
The choice between conservative surgery or a mastectomy It depends on the type of tumor and the clinical characteristics of the patient, as well as the anatomy of the breast. Most patients are candidates for conservative surgery, which involves removing only the area affected by the tumor, ensuring a safety margin. This procedure must then be complemented with the necessary oncological treatments.
In other cases, mastectomies will be required. Sometimes it's the patient's choice, but other times it's due to the location of the tumors, whether they're multifocal, meaning there are many foci of disease in the breast. We must also not forget those patients who carry a mutation and are high-risk. In these cases, mastectomies are necessary. almost always followed by immediate breast reconstruction.
Minimally invasive surgery
As The tumors we detect are getting smaller and smaller and pre-surgery treatments manage to reduce its size, the performance of minimally invasive surgeriesThis involves making incisions that are as inconspicuous and aesthetically pleasing as possible. During the procedure, if necessary, we employ oncoplasty techniques to optimize the aesthetic results.
La oncoplasty It is applied during conservative surgery with the goal of minimizing adverse aesthetic effects. This involves reshaping breast tissue, removing skin if necessary, and reshaping the nipple area to properly center it. Although the priority is to ensure oncological safety, we also pay special attention to aesthetics.
In cases where the lesions are not palpable, are very small, which is fortunately the most common, it is essential locate the lesion before scheduling surgeryOur radiologists place a small seed, a marker, or a coil in the area where the lesion is located, or where it was, if it has disappeared after treatment. In the operating room, we search for this lesion using probes or harpoons, depending on the case, and send the sample to the radiologists. They will use an X-ray to confirm that the lesion has been completely removed, ensuring that the marker indicating its location has been removed. If it is larger piecesAre the pathologists who verify that a complete removal has been performed.
The importance of doing an armpit study
To perform a good staging and good control of breast cancer it is necessary conduct an armpit study. Until not long ago, all the axillary lymph nodes were removed, but today this is done very rarely. Most of the time we will do the selective sentinel node biopsyThis node is the first axillary node that collects all breast drainage, and therefore, we know whether or not it's affected. Otherwise, if the lymph node is disease-free, no more lymph nodes need to be removed.
To locate the sentinel node we use some isotopes, some substances that migrate through the lymphatic system through the breast and are located in the armpit. So after we've injected this isotope into the breast and located where those lymph nodes are, in the operating room, using a small incision in the armpit, we use a probe to find out how many there are (one or two) and remove them so the pathologist can analyze them.
Safe surgeries
Conservative surgeries are clean, fast procedures with minimal complications.In fact, most patients only require one night of hospitalization and are discharged the next day, receiving instructions for wound care at home.
In the event that they are made mastectomies, reconstructions, or, rarely, a complete axillary drainage, a slightly longer hospital stay is required. This is because drains are usually placed to prevent the accumulation of blood and lymph, and these drains can remain in place for up to 48 hours. These patients are usually admitted for two to three nights. Fortunately, Complications such as infections, hematomas, and seromas are rare..
Very high survival rate
Today, thanks to very early and precise diagnoses, as well as a greater understanding of the biology of tumors, which present significant variations in their treatments, We approach each case individually.
Using minimally invasive techniques and complementary therapies including radiation therapy, hormone therapy, targeted therapies, and immunotherapy, we offer multiple options in collaboration with our multidisciplinary team. This allows us to achieve a high cure rate, prolong disease-free intervals and achieve exceptional survival rates.
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If you found this article interesting and would like to be seen by a professional expert in Gynecology and Obstetrics, the Women's Unit at Ruber International Hospital has a specialized unit in this area. You can request more information by calling the following numbers: 91 387 51 72/73/74 or make an appointment for an in-person consultation, always with the best specialists.
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