Radical surgery

Skin-sparing mastectomy (SSM) is a surgical technique used to remove breast glandular tissue through an incision around the areola with skin preservation. The removed tissue can be replaced with an implant or pedicled flap from the back to restore a natural appearance of the breast. From an oncological point of view, SSM is a completely safe surgical technique that does not increase the risk of local recurrence in early stage cancers, multicentric tumors and ductal carcinoma in situ. Pre- and postsurgical irradiation will not be a contraindication for the procedure. In a prophylactic mastectomy setting, SSM is an ideal surgical choice. In selected cases when the mammillary base is not tumor-positive, the procedure can be performed and the nipple-areola complex preserved.

A SSM contraindication is an inflammatory breast tumor involving the skin of the breast. In patients with early breast cancer, SSM is a safe surgical treatment allowing plastic surgeons to achieve quality reconstruction with an excellent cosmetic outcome. At the Eljuga Polyclinic, we have been doing SSM for several years already, and achieved a positive outcome and experience for our patients who have overcome their psychological trauma over the removal of the entire breast.

For patients with breast cancer, regardless of the stage of the disease at diagnosis, a modified radical mastectomy has long been regarded as the only surgical option. Over years, this approach has considerably changed, and mastectomy is no longer as frequent choice. If a tumor is large or thus situated that requires removal of the entire breast, a mastectomy, however, is still the best surgical option.

Surgical removal of the axillary lymph nodes, associated with radical or conservation breast surgery, makes an integral part of surgical treatment for breast cancer. Based on the pathohistological evaluation of the removed nodes, we determine the stage of the disease (pN status) to assess the risk of developing metastatic disease. Pathohistological examination of axillary lymph nodes is therefore a key prognostic factor for decision-making and choosing an adequate systemic therapy.

Surgical procedures to the axilla may vary in their extent, from a lymph node sampling to complete removal of the underarm lymph nodes.

Mastectomy
- A. Breast tissue to be removed shaded in pink
- B. Axillary lymph nodes: level I
- C. Axillary lymph nodes: level II
- D. Axillary lymph nodes: level III

Breast reconstruction following the above radical procedures is our standard option.