Treatment of early detected breast cancer
The question of the choice of methods of surgical treatment of “early” breast cancer has always been and continues to be the subject of debate among surgeons. It should be recalled that the basic principle underlying breast cancer surgery is “ensuring adequate control of a local-regional disease.” Obviously, mastectomy gives good results in which the risk of local recurrence is minimized.
With the defeat of the axillary lymph nodes, this risk is reduced even more if a course of radiation therapy is prescribed after the operation. However, this significantly increases the risk of swelling of the hand (lymphoedema).
As it became apparent that patients with breast cancer did not die from a local disease, but from distant metastases of hematogenous origin, in those cases where it was possible, they began to perform more safe, compared to a mastectomy, surgery. Usually in the United States and Western Europe, conservative breast-preserving operations are preferred, although sometimes (in about 20% of cases) a simple mastectomy with axillary lymph nodes is still used.
Thus, the picture is very different from the one that was 10 years ago. Mastectomy is usually performed in the case of large or retro-aolar tumors (especially with a small mammary gland), with advanced ductal carcinoma, and in the presence of multiple tumor lesions in the gland. Over the past ten years, significant progress has been made in the field of breast plastic surgery, and any technique is now available. Silicone prostheses and reconstruction with the help of a skin-muscular flap are most commonly used.
You can change the shape of the breast, which has a positive effect on the image of a woman, and helps her feel more confident. However, the result of cosmetic surgery is rather mediocre. Usually, nipple reconstruction is not carried out, which is an additional disadvantage. The most successful results were obtained when applying reconstruction using a skin-muscular flap, but this is a longer procedure than reconstruction using a silicone prosthesis.