Breast Surgery and Breast Cancer Treatment: Understanding and Treating Breast Cancer

Breast Cancer Diagnosis – A Turning Point in Life

A breast cancer diagnosis, brings numerous challenges. In addition to choosing the best treatment method, many women face the important decision of whether and how to reconstruct their breast. Thanks to modern surgical techniques, it is now possible to restore both health and the natural shape of the breast as best as possible.

Breast-Conserving Therapy (BCT) – Gentle Treatment for Breast Cancer

Breast-conserving therapy (BCT) is one of the most common treatment methods for breast cancer. During the procedure, the tumor is removed with a safety margin of healthy tissue, while preserving the overall shape of the breast. This method is used in approximately 80% of cases. To ensure a balanced breast shape after the tumor removal, tissue displacement techniques are applied. In over 90% of cases, this results in a symmetrical and aesthetically satisfactory outcome after treatment.

An important technique within BCT is tumor-adapted reduction mammoplasty,where larger amounts of tissue are removed if the tumor is significantly large or located in a difficult position. This method not only allows for tumor removal but also enables breast reduction and lifting, improving the aesthetic result.

In some cases, perforator flaps from nearby areas around the breast are used to replace the removed tissue and maintain the breast shape. This is particularly beneficial as it utilizes tissue from nearby areas of the body.

Following BCT, radiation therapy is usually administered to the breast to minimize the risk of recurrence and support the healing process.

Breast Reconstruction During a Mastectomy – Options for Rebuilding

If a mastectomy is necessary, where the entire breast is removed, there are several reconstruction options. Two main methods are available: implant-based reconstruction and autologous tissue reconstruction.

Implant-Based Reconstruction – Quick Restoration of Breast Shape

Implant-based reconstruction often occurs immediately after tumor removal. This so-called immediate reconstruction offers the advantage of restoring the breast in one surgery. If there is not enough tissue available, a tissue expander can be temporarily used to stretch the skin before placing the final implant. For secondary reconstruction, the implant is inserted during a later operation.

Autologous Tissue Reconstruction – Natural Reconstruction

In autologous tissue reconstruction, the patient’s own tissue is used to restore the breast. Depending on the situation, the blood vessels may either remain connected to the original site (pedicled flap) or be reconnected microsurgically at the new site (free flap). This technique offers a natural and long-lasting solution, as the tissue integrates well into the body. Popular donor sites include the abdomen, buttocks, thighs, and back, with abdominal tissue often providing the additional benefit of a tummy tuck.

Fat Transfer (Lipofilling)– Fine Adjustments for a Harmonious Result

Another method to reconstruct or improve the breast after cancer treatment is fat transfer.  In this technique, fat is harvested from another area of the body using liposuction and injected into the breast. Fat transfer is ideal for making fine corrections and adjusting volume, especially in cases where small irregularities remain after implant or tissue reconstruction. As the patient’s own tissue is used, this method is highly compatible and offers a natural way to reshape the breast.

Lymphadenectomy – The Sentinel Node Technique and Targeted Lymph Node Removal (TAD)

Lymph node removal plays a critical role in breast cancer treatment to assess whether the tumor has spread. One common technique is the sentinel lymph node biopsy,  where only the first lymph nodes in the tumor’s drainage area – the sentinel nodes – are removed. This method reduces the risk of side effects, such as lymphedema, as only the necessary lymph nodes are removed. If the sentinel node is free of cancer, further lymph node removal can often be avoided, which shortens recovery time and reduces the burden on the patient.

Even if the lymph nodes are initially affected, it is not always necessary to remove all of them. With modern therapies, such as chemotherapy, affected lymph nodes can shrink or regress entirely. In such cases, the targeted axillary dissection (TAD) technique is used. The affected lymph node is marked with a clip before therapy, allowing it to be precisely located and removed after treatment. This minimizes the number of lymph nodes removed while ensuring oncological safety.

Which Method is Right for Me?

Choosing the best method of breast reconstruction depends on several factors, including your overall health, the type of tumor, and your personal preferences. I offer expert consultation to help you find the right method for your needs. Together, we will explore the options and find the solution that meets both your health requirements and aesthetic desires.

Your Treatment in Breast Surgery

As an experienced specialist in breast surgery, I will personally guide you through every step of your treatment. My goal is to provide you with the best possible medical care while achieving an aesthetically pleasing result. Your health and well-being are always my top priority.