Both glands in one operation
Synchronous bilateral cancer and BRCA-associated tumors are typical indications: the volume of each side is determined by its stage (radical - with lymph node dissection, prophylactic side - without). Simultaneity eliminates the need for a second operation and anesthesia; reconstruction with expanders can start immediately. Rehabilitation is symmetrical: exercise therapy for both arms, drainage for 3–5 days. The histology of both glands is submitted to the consultation; genetic counseling of the family is part of the protocol for hereditary forms.
Indications
- fibroadenoma growing or 2+ cm, phyllodes tumors - sectoral resection;
- breast cancer - organ-preserving radical resection or mastectomy according to indications;
- BRCA carriage - preventive surgery with reconstruction;
- gland abscess - opening and sanitation;
- defects after oncological operations - reconstruction with implants/lipofilling.
Organ preservation and reconstruction
Modern mammology strives to preserve the breast whenever it is oncologically safe: radical resection with urgent histology of the margins + subsequent radiation therapy is not inferior in survival to mastectomy in the early stages. When mastectomy is necessary, reconstruction (simultaneous or delayed - expander/implant, lipofilling for final correction) restores quality of life. Axillary lymph node dissection is performed as indicated; The IHC profile of the tumor (ER/PR/HER2/Ki-67) determines systemic treatment. All operations are performed with an aesthetic suture.
