Any women undergoing surgery for breast cancer may have the option of breast reconstruction.In the case of a mastectomy, a woman might want to consider having the breast mound rebuilt to restore the breast’s appearance after surgery. In some breast-conserving surgeries, the breast shape might require restoration by mobilizing tissue in and around the breast.
Oncoplasty is mobilizing local tissue in and around the breast to restore the shape and volume of the breast after cancer removal is done. Based on the location, size and number of cancers the type of oncoplasty may differ. Sometimes both the breasts might require oncoplasty to restore symmetry.Awoman may consider havingfat grafting in the affected breast to correct any dimples left from the surgery. The options will depend on each women’s specific situation.
Whole breast reconstruction :
There are several types of reconstructive surgery, although your options may depend on your medical situation and personal preferences. You may have a choice between having breast reconstruction at the same time as the breast cancer surgery (immediate reconstruction) or at a later time (delayed reconstruction).
For whole breast reconstruction, either implant or autologous method is used.
Implant based reconstruction : The whole breast can be removed sparing the skin and or nipple and a suitable implant can be inserted into the skin envelope. Both Saline and Silicon based implants are available. Implant based reconstruction is suitable in the young women with thin or moderate built. However in certain cases where skin or nipple cannot be spared additional skin or flap cover needs to be given.
Autologous Tissue Reconstruction :
Sometimes tissue from elsewhere in the body can be used to rebuild the breast (flap based or microvascular).Tissue based reconstruction is better in certain ways that it is permanent and does not require revision procedures unlike implants. The abdomen, thigh and back are common donor sites for tissue transfer.
Surgery for advanced breast cancer
Although surgery is very unlikely to cure breast cancer that has spread to other parts of the body, it can still be helpful in some situations, either as a way to slow the spread of the cancer, or to help prevent or relieve symptoms from it. For example, surgery might be used:
- When the breast tumor is causing an open wound in the breast (or chest)
- To treat a small number of areas of cancer spread (metastases) in a certain part of the body, such as the brain
- When an area of cancer spread is pressing on the spinal cord
- To treat a blockage in the liver
- To provide relief of pain or other symptoms
If your doctor recommends surgery for advanced breast cancer, it’s important that you understand its goal—whether it’s to try to cure the cancer or to prevent or treat symptoms.
Wire localization to guide surgery
Sometimes, if the cancer in your breast can’t be felt, is hard to find, and/or is difficult to get to, a mammogram or ultrasound may be used to place a wire in the cancerous area to guide the surgeon to the right spot. This is called wire localization or needle localization. If a mammogram is used you may hear the term stereotactic wire localization. Rarely, a MRI might be used if the mammogram or ultrasound are not successful.
After your breast is numbed, a mammogram or ultrasound is used to guide a thin hollow needle to the abnormal area. Once the tip of the needle is in the right spot, a thin wire is put in through the center of the needle. A small hook at the end of the wire keeps it in place. The needle is then taken out. The surgeon uses the wire as a guide to the part of the breast to be removed.
The surgery done as part of the wire localization may be enough to count as breast conserving surgery if the margins are negative. If cancer cells are found at the edge of the removed tissue (also called a positive margin), more surgery may be required.
It should be noted that a wire-localization procedure is sometimes used to perform a surgical biopsy of a suspicious area in the breast to determine if it is cancer or not.