Breast cancer is the most common tumor in women and the third most common in the general population. In the presence of any abnormality in the breast (lump, pain, discharge…) the breast surgeon should be consulted so that he/she can study it and perform the pertinent tests, either a mammography or ultrasound. It has been demonstrated that thanks to early diagnosis, mortality from this disease has been reduced, but exercise, a healthy diet and the elimination of tobacco and alcohol have also had an influence.
Eighty percent of breast cancers develop in women with no risk factors and are considered sporadic. Within the risk factors we differentiate between those that are modifiable and those that are not.
Non-modifiable risk factors
- Female sex: the main risk factor for breast cancer is female sex, but it should not be forgotten that 1% of breast cancer cases occur in men.
- Age: the older the age, the higher the risk of breast cancer; more than 75% of breast cancers occur in people over 50 years of age.
- Genetic factors: mutations in the BRCA1 and BRCA2 genes are especially important.
- Family history of breast cancer.
- Race: it is more frequent in whites.
- Previous breast biopsies with atypia2.
- Women with early menarche (age of first menstrual period), younger than 12 years and with menopause after the age of 50.
- Radiation received: patients who have received radiotherapy to the thorax have a higher risk of breast cancer.
Modifiable risk factors
- Parity: women without children or those who have had their first child after the age of 30 have a higher risk of breast cancer.
- Obesity: Obesity increases the risk of breast cancer.
- Alcohol: Alcohol consumption increases the risk of breast cancer.
- Hormone replacement therapy in menopause more than 5 years.
In general surgery, what exactly is breast surgery?
Breast-conserving surgery, also called lumpectomy, quadrantectomy, partial mastectomy or segmental mastectomy, is a surgery in which only the part of the breast that has cancer is removed. The goal is to remove the cancer and some surrounding normal tissue. In advanced cases of breast cancer it will be necessary to perform a simple or radical mastectomy and in exceptional cases oncoplastic surgery techniques will be combined with reconstructive surgery techniques.
In which cases should breast interventions be performed other than for aesthetic purposes?
- Stage I and II breast cancer (early stage).
- Stage III (locally advanced) breast cancer, after chemotherapy.
- Inflammatory breast cancer, after chemotherapy.
- Paget’s disease of the breast.
- Breast lesions, which by different tests and even with biopsy and there is still doubt of its origin of malignancy.
- Breast abscesses drains.
Mastectomy: what it is and when to resort to it.
Mastectomy is used to remove all breast tissue in patients who have breast cancer or are at high risk for breast cancer. Mastectomy can be used to remove one breast (unilateral mastectomy) or both breasts (bilateral mastectomy).
Women who have had surgery to treat breast cancer can choose from several types of reconstruction. When deciding which is best, you and your doctors should consider factors such as your health and personal preferences. Before making a decision, take the time to learn what options are available to you and consider talking to others who have had this procedure.
Types of breast reconstruction procedures
There are several types of reconstructive surgery, and the reconstruction process may involve more than one operation. Take enough time so that you can make the best decision. You should make the decision about breast reconstruction only after you are fully informed.
- Breast reconstruction with implants.
- Breast reconstruction using your own tissues (flaps).
- Nipple and areola reconstruction after breast surgery.
Sometimes a combination of implant and flap procedures are used to reconstruct the breast. In addition, nipple and areola tattooing and fat grafting can be done to help the reconstructed breast more closely resemble the original breast.
Reconstruction after lumpectomy or partial mastectomy
Most women who have breast-conserving surgery (lumpectomy or partial mastectomy) do not need reconstruction. However, some women may have deformity as a result of cancer surgery; for example, depression formation, caused by removing a large tumor from a small breast.
Some doctors solve this problem by combining cancer surgery and plastic surgery techniques, known as oncoplastic surgery. This involves reshaping the breast during the initial surgery. For example, a partial breast reconstruction may be performed. after breast-conserving surgery or total breast reconstruction can be performed after mastectomy. These women may be candidates for different types of breast reconstruction to shape the breast, including:
- Smaller implants.
- Fat grafting.
- Breast reduction.
- Breast lift.
- Scar revision.
- Smaller tissue flaps.
One or more of these techniques may be used to obtain the best results. In addition, similar results to lumpectomy or partial mastectomy without reconstruction are obtained with this type of surgery.
What happens after breast cancer surgery?
After breast cancer surgery, most women will receive radiation therapy. Some women may also receive other treatments such as hormone therapy or chemotherapy.
What is it like to get back to normal?
Full recovery can take 4 to 8 weeks. You may have stiffness in your shoulder, chest, and arm. This stiffness improves with time and may be relieved with physical therapy. You may have swelling in your arm on the side of the surgery.
If the breast has been removed, when can replacement surgery be performed?
Surgery to reconstruct the breast can be done (or started) at the time of the mastectomy (called immediate reconstruction), or it can be done after the mastectomy incisions have healed and breast cancer therapy is complete (called delayed reconstruction). Delayed reconstruction can occur months or even years after mastectomy.