Introduction
In breast conservation therapy, only the tumor (cancer) in the breast is removed while the remaining healthy breast tissue is preserved. Nowadays, BET is a common procedure, which is usually combined with a subsequent irradiation of the breast. Today, breast-conserving therapy is used for about 75% of breast cancers and can, provided certain criteria are met, offer the same high level of safety in the treatment of breast tumours as amputation.
When is BET for breast cancer possible?
Today, BET is the standard procedure in the treatment of breast cancer. Nevertheless, certain criteria must be met for a BET. These include, among other things, that the tumour is limited in size, i.e. not scattered over the breast, and that the tumour is relatively small compared to the rest of the breast tissue.
Furthermore, the possibility of radiation therapy afterwards should be given. As a rule, a BET is always combined with radiation therapy – the operation together with the radiation therapy is considered to be as safe a treatment procedure as a complete removal of the breast. This topic might also be of interest to you:
- Chemotherapy for breast cancer
When is a BET not possible?
BET cannot be used for inflammatory forms of breast cancer. In this context, the expert refers to an inflammatory breast tumour. Even if the tumour is too large – the tumour is usually considered in relation to the healthy breast – a BET cannot be performed.
In some cases, it is possible to make the tumour “get smaller” by a preceding chemotherapy – so that a BET can be considered after treatment with chemotherapeutic agents. If the tumour does not show clear borders, a BET is also excluded. Furthermore, a subsequent radiation is a criterion for a BET – if this is not feasible or is rejected by the affected persons, this also speaks against a breast-conserving therapy.
Procedure of a BET
A BET is performed by doctors who are active in gynaecology. They are specialized in BET and usually also take over the pre- and post-treatment. In Germany today, there are centres specialising in breast diseases, particularly in the major cities.
In a BET, the surgeons only remove the part of the breast that is tumour-like. The rest of the breast tissue is preserved and often the affected patients notice little or no difference to the non-operated breast afterwards. If a larger amount of tumour tissue is removed, it is possible to subsequently reconstruct the operated breast using the patient’s own fat or implants.
It is also possible to reduce the size of the healthy breast to restore symmetry. Here, the wish of the affected person is the most important factor – some of them do without surgical intervention and use partial prostheses. In addition to the removal of the tumor tissue, it is important to consider the lymph nodes in the immediate vicinity of the tumor.
They may be affected by the tumour cells. As a rule, the lymph nodes are examined before the operation – if they appear conspicuous, a small tissue sample is taken. If these tissue samples are free of tumour cells, only the so-called sentinel lymph nodes are removed during breast-conserving surgery.
However, if the lymph nodes have already been penetrated by tumour cells, the removal of further lymph nodes, especially in the armpits, may be necessary. Experts refer to this as axilla dissection. More about this:
- Lymph node involvement in breast cancer
- Surgery for breast cancer
All articles in this series: