Breast Diseases and Breast Tumor Surgery
October 25, 2021 / By Nihat.Gulaydin-2021 / Posted in General Surgery
The breast is the organ responsible for the milk production required for newborn development in women and works under the influence of hormones.
Benign diseases of the breast
Fibrocystic disease, benign breast masses such as fibroadenoma, microbial mastitis and non-microbial granulomatous mastitis, and ductal ectasia are the most common. These diseases are not life-threatening lesions and should be followed up after specific treatment. If fibroadenomas tend to grow, they must be removed. Abscesses are drained and antibiotic therapy is given. In granulomatous mastopathy, the cause is investigated and treatment is arranged.
The most common breast complaints are breast pain, which we call mastodynia, and palpable masses in the breast. The most common cause of mastodynia is fibrocystic breast disease, which usually occurs in the form of swelling and tenderness in the breast during menstrual periods. In this type of pain, painkillers and some special medications are started.
For our patients who apply due to a breast mass, preliminary evaluations are made by examination, USG, mammography and MRI depending on their age. In suspicious masses, diagnosis must be made by biopsy.
Malignant diseases of the breast
Invasive ductal carcinoma, invasive lobular carcinoma and others. Patients diagnosed with breast cancer are brought to the breast council after PET-CT is performed in addition to the existing examinations, where a treatment plan is created.
In the current management of breast tumors, a group of patients are treated with chemotherapy (neoadjuvant therapy) before surgery. Thanks to this treatment, locally advanced tumors can be better controlled and treatment success increases. After neoadjuvant treatment, the patient undergoes surgical treatment. In surgery, the aim is to completely remove the existing tumor tissue macroscopically, as well as to identify possible axillary lymph node spread and, if necessary, to clean the armpit lymph nodes, which we call the axilla. Surgical competence is very important. For this purpose, MRI and PET-CT evaluations should definitely be taken into consideration.
The main goal in breast tumors is early diagnosis.
In diseases detected in the early stages, patients recover completely from the disease, while this probability decreases in the late stages.
For this purpose, screening programs are carried out by the Ministry of Health in our country, and mammography is performed free of charge in Maternal and Child health centers for women aged 40 and over.
Every woman should have a self-examination at certain periods, and patients aged 35 and over who have a family history of breast cancer, and every woman over the age of 40, even if she does not have a family history, should undergo breast examination and screening.
The main method of breast screening is examination and evaluation by mammography.
In some patients, breast MRI or USG may be the first test, depending on the doctor's preference.
Today, oncoplastic surgery is the main approach. When performing surgery, the breast tissue, which is very valuable for the patient, must be protected to the maximum and its shape must be created as close to natural as possible.
Different flap surgeries and prostheses are used for this purpose.