Why a breast pathology unit?
The need for a breast pathology unit arises as an answer to the measures intended for the improvement of the assistance in this pathology, based on the best possible scientific evidences. In the last few years, the best possible assistance is an offer of the following aspects with oncological security:
- Conservative surgical techniques
- Sentinel node identification
- Masectomy related to immediate reconstruction when the illness is local or multicentric
The unit must guarantee that the patient receives the treatment recommended by the scientific studies and worldwide experts that are involved in this pathology. To achieve this goal, the sanitary professionals must be interested in this specific pathology and they must receive methodological support based on the guidelines provided at periodical meetings with the rest of the members of the unit.
“Our breast unit”
We diagnose at least 100-125 new cases each year. Each member of the unit offers their compromise and special dedication. The team includes a general surgeon, plastic surgeon, clinic oncologist, radiotherapeutic oncologist, radiologist, pathologist, nuclear medicine service, psychologist, nurse expert on the special treatments and drainage of this breast surgery.
Each patient receives a personal report in order to provide the best possible treatment, considering the principles of oncologic radicality as well as cosmetics. We know that “each breast cancer is unique”..
Compromises of our breast unit
- All patients derived to our unit will meet their specialist within 3 days.
- We ensure the maximum coordination between the members of the unit in order to perform a clinical exploration, radiologic imaging and even a core biopsy or fine needle aspiration in the same appointment.
- The results regarding the benign or malignant nature of the illness will be delivered within 10 days.
- Once a week, we hold a multidisciplinary meeting to evaluate the diagnosis and the individual treatment of each patient.
- Sentinel node implant in all indicated cases.
- Conservative surgery as long as the relation between the tumor and breast size permits it.
- If the cancer extension requires a mastectomy, our surgeons will offer immediate reconstruction techniques (expanders or breast prosthesis).
- When the treatment is finished, all checkups will take place in the breast unit.
- We also offer psychologic support in case it is necessary.
- The patient’s relatives can also access experts on genetics in order to identify any risks of developing the same breast cancer: “the best treatment is an early intervention”.
Conservative surgery indications
- Negative margins are possible, reducing the tumor to microscopic limits.
- Favorable relation between tumor and gland size with good cosmetic results.
- Tumor one quadrant only
- The patient can receive radiotherapy without any risks.
Immediate reconstruction after radical mastectomy
Radical mastectomy is indicated in the following cases:
- Multicentric illness (extended at least to two of the four quadrants: upper-outer, upper-inner, lower-outer and lower-inner).
- Impossibility of radiotherapy after surgery (related collagen illnesses, breast cancer while pregnant, previous radiotherapy).
- Inadequate relation between tumor and gland size.
- The radical surgery has two stages:
- In the first surgery, we perform a radical mastectomy and place an expander where the breast was located. This expander is similar to a “bag”: it is filled with serum in several sessions in order to generate a wide pocket of skin and muscles in which the definitive prosthesis will be placed. The filling sessions take place in the outpatient department during the chemotherapy treatment.
- After chemotherapy and radiotherapy (when these are indicated), we proceed with a second surgery in which we place the definitive prosthesis. Many women take the opportunity to “rejuvenate” the contra-lateral healthy breast and attain symmetry.
Advantages of sentinel node
The selective sentinel node biopsy consists on studying the first axillary node that receives the lymphatic drainage of breast cancer.
The goal is performing a selective lymphadenectomy, only in those cases where the node has been invaded. Therefore, the surgical process is adapted to the tumoral stage and hence avoiding unnecessary and harmful removals.
The procedure present an almost absentmorbility and requires the integration of different specialists in a multidisciplinary team (surgery, nuclear medicine and pathological anatomy).
The “side effect” of this produce is a small 2 cm incision in the axillary gap.
Monitoring after surgery
Periodic controls by specialists on:
- Plastic surgery
- Psychology (if needed)