“With the tissues removed from the patient’s belly, back or hip, the breast can be reconstructed.”

Head of Anadolu Health Center Plastic and Reconstructive Section Op.Dr.Tuğrul Kihtir answered our questions on the topic of surgical treatment of breast cancer :

What is the surgical treatment of breast cancer?
In the last 10 years significant changes happened in the treatment of breast cancer. Today instead of the removal of the entire tissue of the breast tissue (mastectomy) , breast preventive treatment in which we remove only the cancerous tissue came to the forefront.

In what conditions is chemotherapy applied to the patient and which surgical interference is made? It is an important issue as to whether chemotherapy will or not be given to the patient. Here what should be known is the dimensions of the tumor, as to whether it has skipped to the under armpit lymph nodes and if there is or not metastasis. In situations when tumor dimensions are very large and in cases metastasis is encountered, chemotherapy can be given before surgical interference.

SOMETIMES INESCAPABLE

In what situation is the breast removed totally?
Mastectomy is still the valid surgical method in the tumors which have reached large dimensions because of retarded diagnosis, in tumors seen in more than one localization
and in some tumor pathologies. In our day in the modern breast centers, women’s psychological problems developing after mastectomy have been lowered to minimum since it is possible to perform reconstruction in the same session when the breast tissue is removed working in collaboration with the plastic surgery department.

PERFORMED IMMEDIATELY

What is breast reconstruction?
Generally it is the reconstruction of the breast removed surgically because of breast cancer.
Reconstruction is actualized either by the help of silicon or physiological serum containing prosthesis (implants), or by the use of patient’s own tissue (autogen). As this can be performed right after mastectomy, before the patient recovers, it can be performed even after years.

How is breast reconstruction actualized through the use of prosthesis?
Technically, in reconstructions actualized through prosthesis, the skin of the breast removed after being expanded by the help of an expander prosthesis in 2-6 months, a permanent prosthesis is placed . The prostheses can be with silicone, physiological serum or a combination of these. In like manner prosthesis in varying forms or sizes exist. A method which can be mentioned as a new one is the use of expandable prosthesis. Here after the expandable prosthesis is placed, it is left in place for 2-3 months by watching its
expanding. In this method, the second operation in which the permanent prosthesis is placed is rendered unnecessary.

*Can breast be reconstructed by the use of patient’s own tissue? Yes, technically
in breast reconstruction in which patient’s own issues are used (autogeneus), flaps from different tissues can be made use of. These can be taken from the belly wall, back and hip areas. In the use of TRAM flap which is the mostly applied, the belly skin is removed with its underlying excess fat and muscle tissue or as it is connected to its root (with pedicule) to the breast area or as a free flap it is placed in the breast area through microsurgery methods. Here as the own tissue of the patient is used, it is possible to construct breast with both natural appearance and consistent and the excess tissue in the belly is being eliminated . Autogeneous breast construction is a more detailed and longer interference in comparison to the reconstruction in which prosthesis is used and the duration of stay in hospital is 2-3 days more.