The Breast Unit at Paideia International Hospital offers a comprehensive pathway in the treatment and care of women with breast cancer. The multidisciplinary unit guarantees high standards of care by experienced staff using innovative treatments. Scientific studies show that women treated in these kinds of units have a higher chance of surviving breast cancer.
Breast surgery as a fundamental part of cancer treatment
An essential part of cancer treatment is breast surgery. Breast tumours are surgically treated to control the disease locally with the hope of permanently eliminating the disease. Breast surgery can be conservative or demolitive, with the most appropriate procedure suggested by the surgical team.
Conservative surgery
Benign lesion surgery: tumorectomy and/or removing a portion of breast tissue including the lump.
Quadrantectomy: removing a large section (quadrant) of mammary gland including the tumour with or without overlying skin with a healthy resection margin. The remaining part of the breast is preserved.
Oncoplastic surgery: conservative breast surgery is increasingly being combined with plastic surgery techniques to improve the woman’s physical integrity. Hence, there are now “oncoplastic” surgeries that, while respecting the resection requirements of good oncological surgery, also end with satisfying aesthetic results.
Breast surgery: reconstruction after quadrantectomy
Several remodelling/mastoplasty techniques are used alongside quadrantectomy to compensate for the physical impact of surgery to remove cancer. The customised reconstruction pathway may also include symmetrisation of the healthy breast. After assessing the (oncological) impact of the surgery in terms of the shape and volume of the post-surgery breast, the patient may be offered the simultaneous (at the time as the cancer surgery) correction of the healthy breast.
Oncoplastic Surgery
- Mammoplasty or Glandular Remodelling after removal of tumour
- Contralateral Breast Symmetrisation Mammoplasty
Demolitive surgery
Nipple Sparing Mastectomy (NSM): Skin and nipple-areola complex sparing mastectomy This can also be the best technique for prophylactic mastectomies recommended for patients who carry the genetic mutation BRCA, which carries a high risk of developing breast cancer.
Skin Sparing Mastectomy (SSM): mastectomy with skin sparing but not nipple sparing.
Skin Reducing Mastectomy (SRM): mastectomy with partial skin removal and reimplantation of the nipple-areola complex.
Simple Mastectomy: Removal of the entire mammary gland and an overlying diamond-shaped piece of skin that makes up the nipple-areola complex.
Radical mastectomy: removal of the entire mammary gland associated with the removal of lymph nodes from the armpit with or without the removal of chest muscles.
Reconstruction after mastectomy in breast surgery
Mastectomy techniques must be combined with advanced, state-of-the-art reconstructive techniques to make best use of the skin or areola/nipple for high-quality reconstruction. Reconstruction, except in special cases, is carried out immediately after removal of the gland.
Reconstructive procedures:
- Reconstruction with expander/prosthesis
- Prepectoral technique with prosthesis
- Retromuscular technique with prosthesis
- Reconstruction with autologous tissue (pedicled or free flaps)
- Surgery with adipose-derived regenerative cells (lipofilling)
Axillary lymph node dissection
In all operations, dissecting the axillary lymph nodes may be necessary.
Sentinel lymph node biopsy: searching for and removing the first of the lymph nodes in the armpit that drain the breast and thus the tumour.
Axillary lymphadenectomy: completely removing axillary lymph nodes (when the axillary lymph node is metastatic).
Regenerative breast surgery
- Treating fibrotic scarring or periprosthetic capsule in reconstruction after mastectomy
- Treating damage caused by radiotherapy after quadrantectomy or mastectomy
- Treating scars
- Vulvovaginal atrophy or dystrophy after early menopause due to adjuvant hormone therapies in treating breast cancer
- Regenerative fat cells for cases of unsatisfactory cosmetic surgery results
Rupture of prosthetic implants or unsatisfactory reconstruction results
Paideia International Hospital also supports secondary operations in both reconstructive and cosmetic surgery cases involving:
- Fibrosis or Deformity
- Periprosthetic capsule with hardening of the prosthetic implant
- Implant rupture
In these cases, it is often necessary to combine simple prosthetic replacement with regenerative surgery based on the regenerative properties of adipose tissue cells. These techniques, which use fat cells taken from the patient by liposuction and then processed, restore the normal tissue elasticity of the subcutaneous tissue that is hardened or retracted. The restoration of normality in the tissue and the use of technologically reliable prostheses guarantee a satisfactory result.
