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brustzentrum@usz.ch
Surgery for breast cancer
Once a diagnosis of breast cancer has been made, treatment usually begins with an operation. Although 80 to 90 percent of all breast cancers are curable, imminent surgical treatment raises questions.
Is breast-conserving surgery possible?
In over 70 percent of all cases, the breast remains intact. The following requirements must be met:
- the disease must not yet have spread widely
- the disease must not be present at different sites
In addition, the ratio between tumor and breast size is crucial, as healthy tissue must always be removed during the operation. In the case of small tumors in a large breast, breast-conserving surgery is usually very well possible, whereas in the case of large tumors in a small breast it is not.
Do all the lymph nodes in the armpit have to be removed?
Whether all lymph nodes need to be removed depends on whether breast cancer cells have already infiltrated the lymphatic system.
The sentinel technique is used to find this out. This involves trying to locate the so-called sentinel lymph node, as this is the first to be affected by the tumor. The sentinel lymph node is removed and examined microscopically.
If no tumor cells are found, in 95 percent of cases all other axillary lymph nodes are also tumor-free. This means they do not have to be removed. The patient experiences no restriction of movement and the risk of lymphoedema is significantly reduced.
How can a cosmetic balance be created?
Depending on the size of the healthy breast, the lost tissue can be replicated with silicone prostheses that are inserted under the skin and pectoral muscle. Under certain conditions, these silicone implants can be inserted directly after tumor removal in the same operation.
A breast can also be reconstructed from the body’s own tissue from the back, abdomen or thigh (
plastic surgery
). External options such as special bras with breast prostheses are also available.
In certain situations, breast reconstruction can be performed immediately – i.e. during the operation – or after a certain time interval.
The form in which breast reconstruction can take place is explained in detail in a joint consultation with the surgeons (Breast Center and Plastic Surgery) and then carried out according to the patient’s wishes.