Purulent mastitis
An abscess develops from stagnation and cracks during feeding or outside of lactation (smoking, cysts): Ultrasound confirms the cavity, and delay leads to tissue destruction. The incision is planned along aesthetic lines, taking into account the ducts; the cavity is washed, the partitions are separated, drainage is carried out for 2–4 days; Sowing the pus is clarified by an antibiotic. Lactation: breast pump on the healthy side and, as directed by a doctor, breastfeeding - milk suppression is rarely required. Small abscesses are sometimes treated with punctures under ultrasound - the doctor will choose a gentle option. Monitoring of healing and ultrasound until the cavity is completely closed.
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.
