The breast cancer treatment
Written by:Breast cancer is the most common cancer in women. In Italy there are annually about 50,000 new cases of breast cancer. the Dr.. Giuliano Antonio Luciani, General Surgeon in Milan , an expert in the treatment of this cancer, talks about the therapy to combat it
1) What should a woman who has been diagnosed with breast cancer?
When a woman is suspected of having a breast disease (because she found a lump or has noticed a breast deformation or nipple), or when the disease has already been diagnosed, should consult a breast specialist. Majoring in Senologia not exist, but there are courses or masters organized by university institutes or centers of excellence, which issue a diploma in this medical branch.
Tests for diagnosis of breast cancer are usually prescribed by the patient's GP and are represented, initially, by:
- Mammography, only effective when the breast has lost the high consistency of youth, and then to 40 years;
- Ultrasound, performed even in young women.
The two tests are complementary, in that each is able to reveal peculiar characteristics of the nodule.
In these examinations is added the clinical breast examination and, in case of need, you can ask insights as the 'needle aspiration with fine needle (which picks up only cells for cytologic examination) or needle biopsy (which, under local anesthesia, picks up a small carrot tissue for histological examination).
In case of necessity, it may also be required with an MRI contrast medium, examination today used for the study of the breasts with prosthesis or in the suspicion of the presence of more tumor nodules.
All of these tests can define the size, histological type and the biology of the tumor, such as sensitivity to hormones, the growth capacity or the presence of particular genes on the cell surface. Made the diagnosis, the patient must necessarily be taken into care by multidisciplinary a Team, consisting of the breast surgeon, oncologist, the Radiation Oncologist and, if necessary, by the psychologist, who will help overcome the impact of the disease.
2) What does the normal procedure for the treatment of breast cancer?
The counseling will be discussed by Equipe, which will determine whether to undergoing an operation to remove the tumor or surgery to precede by a Primary or Neoadjuvant Chemotherapy, which has the intent to reduce the size of the tumor to allow an intervention conservative and not demolitive as is the mastectomy.
3) What is the surgery for breast cancer?
If you decide for immediate surgery, as happens in most cases, one can make a conservative surgery which consists in removing the tumor leaving a margin of healthy tissue around the same.
Surgical techniques have been refined in recent years: plastic surgery helps to avoid deformations of the breast profile and to adjust the volume of the healthy breast to that of the operated breast.
The mastectomy (the removal of the entire breast) is not, however, abandoned. Must undergo this surgery women with multiple tumors in the same breast, those in which the Primary Chemotherapy was ineffective or those with such a small gland does not allow an aesthetically valid conservation.
During the operation, you can search for the sentinel node technique for removing and immediately examine the first lymph node that filters lymph from the region where the tumor is located. If the lymph node present of tumor metastases, you will have to remove all the other lymph glands. If the lymph node metastases were demonstrated in the preoperative phase, it will proceed to the removal of all the armpit glands during surgery, without searching sentinel node.
4) After surgery, what happens in the womb?
The possibility of an immediate reconstruction of the breast removed, at the time of first intervention, using a prosthesis, it must be offered to all women. In case it is also removed the nipple, you will also perform the reconstruction of this with a simple plastic surgery. The tattoo of the areola will complete the reconstruction.
5) The breast cancer treatment involves a post-operative therapy?
After surgery will take another multidisciplinary discussion during which they will decide whether to make a chemotherapy and / or hormone therapy with products that block hormones and, if it is necessary, a radiation therapy, compulsory treatment in the case of a conservative surgery.
The treatment with chemotherapeutic and / or antiormoni has the function of destroying the circulating tumor cells before they can give metastases, while the full radiotherapy surgery reducing the risk of local recurrence.
After the post-operative treatment, which can last six to eight months and may be extended for several years with hormone therapy when it was shown, the patient will be subject to regular checks, typically six months, to assess his health and to oversee any recurrence of the tumor in the breast operated or the appearance of new tumors.
In case of tumors diagnosed at early stage, complete healing reaches percentages above 90%.