Onco Surgery
🍈 Breast Cancer
false - Lymph
superficial + profound plexus
BRCA 1, 2
↑RISK FOR BC
“Sclerosing adenosis (SA) is a benign proliferative condition of the terminal duct lobular units characterized by an increased number of acini and their glands. It manifests as multiple small, firm, tender nodules, fibrous tissue, and variable microcysts within the breast.”
- atypical ductal, lobular hyperplasia 📷
- in situ lobular carcinoma
- ALCOHOL
- OBESITY + HIGH FAT DIET
- CONTRACEPTIVES
- HORMON REPLACEMENT
- surgical (after 2 uncertain punctures)
- excisional (small lesions that cant be punctured)
other reasons: technical reasons, microcalcification without mass on US, No opage center just distorsion, refusal
sentinel lymph node 📷
axillary, internal mammary, infraclavicular, supraclavicular 📷
lung, liver, brain, bones 📷
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Check everything for mets
- Chest X-Ray
- abdomino-pelvic US,
- Bone radiographs+/- scintigraphy, (if bone pain)
- CT scan of skull (if neurological symptoms)
- any other suggested by specific symptoms
CA 15-3
- Liver function
- ALP
- Renal function
Lymphoscintigraphy 📷
conversion to operability, inflammatory carcinoma, breast preservation, sensitivity testing of primary tumor chemotherapy
Trastuzumab→ in HER2 positive cancer
TOGETHER WITH CHEMO
- hormonal therapy
- chemo
lumpectomy, wide excision, quadrantectomy (all breast-conserving) and mastectomy
with oncolocic margins
dye 📷
adjuvant therapy
RADIOTHERAPY MANDATORY IN CONSERVATIVE TREATMENT
homonal, chemo, trastuzumab
periodic controls at 3 months in the first 2 years
→at 6 months in the next 3-5 years,
→then annual controls;
- anamnesis and objective examination;
- ippsilateral mammography and contralateral at 1 year;
- in the case of symptomatic or pathological changes at the objective examination→ targeted additional examinations
- Breast MRI may be indicated in young patients with dense breasts and genetic / familial predisposition - discussion in CDT;
- for patients undergoing hormone therapy with Tamoxifen, an annual gynecological consultation is recommended
- for patients undergoing hormone therapy with aromatase inhibitors, periodic evaluation of bone density is recommended;