Standard organ-preserving
Indications: tumor up to 3–4 cm with sufficient gland volume, lack of multicentricity, possibility of radiation therapy after. Excision with edges of 1+ cm, marking of the bed with clips (for guiding radiation therapy), lymph node dissection at different levels, taking care of the nerves. Drainage 2–4 days; The cosmetic result is achieved immediately by moving the tissue. Histology + IHC is submitted to a consultation in 10–14 days: hormone therapy/chemo/target by subtype. Observation and mammography according to the oncologist’s schedule.
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.
