Blog

The medical arsenal against breast cancer is constantly being strengthened with new, less invasive surgical techniques, which have often replaced more radical approaches, such as mastectomy, and – in combination with a series of new drugs – give hope to thousands of women.

Surgical treatment aims to remove the cancer from the breast and ensure that the disease does not recur. Together with established therapeutic approaches, such as chemotherapy and radiotherapy, surgical treatment is at the core of every treatment plan.

However, in recent years, extensive surgeries and radical surgical techniques, such as mastectomy, have begun to give way to approaches that are specifically tailored to the needs and goals of each patient.

Minimally invasive methods of treating breast cancer are now the first choice for the treatment of most cases. On the contrary, radical surgical techniques are used less and less frequently, reflecting the tendency of surgeons internationally to seek to preserve the breast of their patients.

With modern approaches, we can now operate on small cancers, non-palpable lesions without having to remove a large part of the breast. And all this without any reduction in the oncological result, which is non-negotiable.

The new trends in the surgical treatment of breast cancer can be summarized as follows:

• Breast conservation. Breast conservation is the treatment of choice in almost 85% of surgeries, while even in cases where mastectomy is unavoidable, mastectomy and simultaneous reconstruction techniques have now been developed that include the preservation of the skin and the nipple/areola complex. Breast conservation techniques include lumpectomy or quarterectomy. During lumpectomy, the tumor is removed but the rest of the breast is preserved, as long as the tumor is not too large or the cancer is not located in multiple places within the breast.
• Oncoplastic techniques. The application of oncoplastic surgery techniques in the treatment of breast cancer allows the resection of the affected part of the breast, with excellent results not only oncologically but also aesthetically, often improving the appearance of the breasts! With oncoplastic techniques, the surgeon can remove a large part of the breast while maintaining its shape and avoiding deformities.
• Simultaneous reconstruction. In the past, plastic reconstruction of the female breast after surgery for breast cancer was time-consuming and was performed much later than the surgery, negatively affecting the patient’s psychological state. Now, however, it is possible to combine proper oncological surgery with advanced plastic techniques, so that breast reconstruction can be performed immediately and not in the distant future. Breast reconstruction simultaneously with oncological surgery is completely safe and does not affect the possibility of receiving complementary chemotherapy.
• Sentinel lymph node biopsy. The identification and removal of the “sentinel” lymph node instead of all the axillary lymph nodes, constitutes a major revolution in Breast Surgery. The sentinel lymph node is the first to receive cancer cells from the breast, which makes the information about its infiltration or not very important. Therefore, after being marked with a special technique preoperatively (technetium injection) during surgery, it is identified and removed in order to perform a rapid biopsy. The result will be evaluated by the treating physician and will be important information for the staging of the patient. Most of the time, lymph node dissection will be avoided, with its extremely high morbidity and the long-term problems it creates in the quality of life of patients.
• The above approaches constitute significant developments that greatly differentiate the way Breast Cancer is treated compared to the past. The integration of these approaches, as well as any new innovation in clinical practice, is a daily practice at the Athens Medical Center, always taking into account the needs and expectations of each patient.