Procedure of the surgery | Surgery for breast cancer

Procedure of the surgery

The operation is performed under general anesthesia and in supine position. Only the affected breast including armpit and head are exposed, the rest is covered. In breast-conserving surgery, an arch-shaped incision is made over the palpable or wire-marked tumor inside the breast.

The tumor is then removed with a sufficient safety distance to the surrounding healthy tissue. The skin that lies above the tumor is also removed. Depending on the proximity of the tumor to the nipple, the nipple is also removed.

The lymph nodes in the armpit are removed with a second incision if the tumor is too far away from the armpit. At the end of the operation the skin is sutured together without tension. A complex reconstruction of the breast is usually not necessary with this method, as the amount of tissue removed is relatively small.

In the modified radical mastectomy, a spindle-shaped incision is made from the sternum to the armpit, so that it runs along the top and bottom of the breast. Such an incision facilitates subsequent reconstruction of the breast. All the glands and fatty tissue of the breast, as well as the skin and nipple, are then removed.

Furthermore, the cover of the large pectoral muscle, which is located under the breast, is removed. The muscle itself remains undamaged and only needs to be removed if it is also affected by the tumor. Next, the fatty tissue in the armpit up to the axillary vein is removed.

The surgical field thus includes the breast and the armpit. If no radiation is planned after the operation, a placeholder can be inserted where the breast once was, which is the first step for a future reconstruction of the breast.With this method, too, the wound edges are sutured tension-free at the end and a tube is inserted into the surgical area so that any wound fluid can drain away through this tube. With both methods, a pressure bandage can be applied over the wound at the end to prevent more severe bleeding.