Q: Can breast-conserving surgery be performed even for breast cancer?
A: With the emphasis on early detection of breast cancer and the popular use of mammography, the number of early cases with small tumors is gradually increasing, and breast-conserving surgery has come into being.
Q: Are there any requirements for breast-conserving surgery?
A: In China, the following conditions are usually recommended as reference for case selection.
1, single clinical and mammographic cancer focus.
2.Tumor diameter Q3cm and more than 2cm from the nipple.
3, no local progressive symptoms.
4, no metastasis or individual metastasis in axillary lymph nodes.
5, good nuclear differentiation and histological grading of the tumor.
6, age 30-60 years.
7. The patient agrees to breast-conserving surgery and there are no absolute contraindications.
8.Patients with strong demand for breast-conserving surgery after treatment to stage I or II in individual cases with more advanced localization.
Q: Under what circumstances can breast-conserving surgery not be performed?
A: Breast-conserving surgery cannot be performed in the following cases
1.Multiple primary foci.
2.The affected breast has received radiotherapy, during pregnancy, or the surgical margin cannot be negative
3.Cancerous tumor is located in the center of the breast and has collagen disease that cannot tolerate radiotherapy.
Q: What is the extent of breast-conserving surgery?
A: The extent of excision should be more than 2cm from the tumor margin. The edge of the excised specimen is routinely examined by pathological examination of frozen section until the edge of excision is negative.
Q: Do I need to clear the axillary lymph nodes for breast-conserving surgery?
A: According to the anatomical theory, the first lymph node that is reached by the lymphatic circulation of the breast to the axilla is the “sentinel lymph node”. If the breast cancer metastasizes there, the cancer cells will be temporarily blocked by this defense barrier and will only continue to metastasize to the next station. If there is no cancer invasion in the sentinel lymph node and the lymphatic drainage route is not damaged, it means that no cancer cells have reached this area and the subsequent lymph nodes may not be invaded by cancer cells, therefore, axillary lymph node dissection is not possible. If the anterior lymph nodes are invaded by cancer, then axillary lymph node dissection should be performed.
Q: What is the follow-up treatment of breast-conserving surgery?
A: Because distant metastasis (bloodstream metastasis) of breast cancer can precede lymph node metastasis. Breast
Breast cancer should be treated as a systemic disease in its early stage, and a combination of therapies should be used before it can be cured. Breast-conserving surgery plus local radiotherapy can significantly reduce local recurrence, while axillary radiotherapy should be added for axillary lymph node metastasis, followed by adjuvant chemotherapy for estrogen receptor positivity.
Q: Is breast-conserving surgery prone to recurrence?
A: Local recurrence of breast-conserving surgery is one of the main concerns of this procedure. Although radiotherapy can eliminate most of the subclinical cancer foci, there is still a possibility of residual recurrence.
Q: How to evaluate breast-conserving surgery?
A: Most of the women in China have medium-sized breasts, and breast-conserving surgery should be strictly controlled by the indications.
Breast-conserving surgery should strictly control the indications, pay attention to the medical effect and prevent recurrence, and its long-term effect is still good.