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Until recently, the diagnosis of breast cancer was associated with the need to remove the breast. Today, more and more women are offered BCT therapy - a procedure consisting in removing only a part of the breast and preserving the lymph nodes under the armpit. What do you need to know about breast conserving surgery?

The number of new cases ofbreast canceris huge - 12,000 annually. Fortunately, women see their doctor more and more often whenbreast canceris still in its early stages. This is what makes it possible to decide on a breast conserving treatment -BCT(breast conserving treatment). This applies to about 30 percent. women. In the world, suchbreast-saving surgeriesare performed in 50-70 percent. women with breast cancer.

Breast cancer: for whom the conservative surgery is

Surgery to conserve the breast and lymph nodes can be performed when:

  • the diameter of the nodule does not exceed 2-3 cm, so in the so-called early stages of the disease. But even in such cases, after surgery, radio-, chemo- or hormone therapy is necessary. However, the sooner a woman goes to the doctor, the greater her chances of full recovery;

When the nodule is larger, conserving surgery is impossible (in individual cases, such treatment can be performed after induction chemotherapy, but qualification for such treatment is made at the meetings of a multidisciplinary consultation team).

  • mammography shows only one tumor;
  • the tumor is not a large part of the breast. When the breast is small, even a few centimeters lump can be a significant part of it. The size of the breast is important as it allows you to remove the tumor with an adequate margin of he althy tissue;
  • there is a possibility of close cooperation between the radiologist, pathologist, surgeon, radiotherapist and chemotherapist, and the patient is involved in the treatment process and can come to the next therapies regularly.

Breast conserving surgery: leave the guard - sentinel knot

Breast amputation is a radical and quick treatment, but it can cause other he alth problems, e.g. limiting hand movements, and sometimes also severe neurosis or depression. Thanks to the treatmentthe saver and the so-called the sentinel knot method can not only save the breast, but also preserve the lymph nodes under the armpit. During mastectomy, not only the entire breast is removed, but also 10-30 nodes under the armpit just in case.

Important

Breast examinations

It takes several years for the tumor to reach a diameter of 1 cm; It takes 6-8 years for it to grow to 2 cm. That is why research is so important. If we examine the breasts after each menstruation and - in accordance with the doctor's recommendations - perform ultrasound and mammography on time, we ensure a safe future, because this is the only way to detect pre-invasive cancer. This means that the cancer cells did not come into contact with the blood, i.e. they did not spread throughout the body and did not reach, for example, the lymph nodes. At this stage, you can think about saving the breast and, more importantly, curing the cancer.

Sparing surgery: contraindications

  • cancer is multicenter
  • there are extensive microcalcifications
  • the tumor is too big
  • the woman had irradiation of both breasts
  • there are connective tissue diseases - they can cause significant tissue fibrosis in the operated breast
  • the patient is in a generally bad condition (lung and heart diseases).

The doctor may advise against performing a sparing procedure if the woman has very small breasts and the end result of the operation will be almost the same as with a mastectomy.

The BCT method has many advantages

  • makes sure that the tumor has attacked only the breast
  • the operation takes less than radical surgery the risk of postoperative complications on the breast is reduced and a small scar remains under the arm
  • long-term rehabilitation of the hand is not necessary after the procedure.

Most women who have had their breast removed suffer from reduced hand movements, swelling or pain. Today, it is possible to save lymph nodes thanks to a precise method of determining whether the nodes in the armpit are attacked by cancer developing in the breast.

Lymph nodes are a kind of filters that trap substances that may endanger our he alth. At strategic points in the body (neck, armpits, abdomen, groin and chest) antibodies and food cells are constantly being built up to destroy bacteria, viruses and cancer cells. When an infection begins to develop in the body, the nodes defending certain areas of our body immediately increase in size. For example, when a pharyngitis develops, the lymph nodes in the neck increase. This feature was used in the new research method. Thanks to her, the doctormakes sure that there are cancer cells in the node adjacent to the sick breast. If not, only the nodule is removed.

Breast surgery: sentinel lymph node

In examining the sentinel knot, the possibility of staining it plays an important role, thanks to which the doctor can easily distinguish the strategic knot from others. In practice, the day before surgery, a radioactive isotope is injected into the area of ​​the nodule. This allows you to see to which node the lymph is draining from the diseased breast. This is an important moment for the next steps. The next day, during the operation, a blue dye is injected into the breast, which travels with the lymph under the armpit, coloring the knot blue. Thanks to the presence of the isotope, the places where the cancerous cells from the breast have accumulated are precisely marked. A sample is taken from the blue node for histopathological examination. If it turns out that there are no cancer cells in it, the lymph nodes do not need to be removed. This is the case of 90-95 percent. tumors that do not exceed 2 cm in size.

Breast cancer: after conserving surgery

A sparing operation is only the first stage of treatment. Irradiation is an inseparable part of the therapy, because they prevent the cancer from reappearing. Individual radiotherapy sessions are short, only a few minutes, but the entire radiation treatment lasts 5-6 weeks. After radiotherapy treatments, a local radiation reaction may appear - the skin is peeling or slightly browning. However, over time, the tissue on the breast regenerates and does not look much different from a he althy breast. A sparing surgery is not a substitute for general treatment such as chemotherapy and hormone therapy. Hormonal medications can be taken simultaneously with radiation therapy. In contrast, chemotherapeutic agents are currently most commonly administered after surgical treatment and before irradiation sessions. Only after the end of chemotherapy, which lasts 4-6 months, radiation therapy begins. Then the entire treatment may take more than 8 months. After that, regular checks in the hospital are necessary so that it is possible to notice in time a possible recurrence of the neoplastic disease, which - unfortunately - is possible. However, studies show that the likelihood of relapse-free survival after conserving surgery is no different from that after complete breast amputation and removal of the lymph nodes.

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Category:

Oncology