ONCOPLASTIC SURGERY
Oncoplastic surgery is a new concept in surgery in which the knowledge of plastic surgery is combined with the knowledge of oncologic surgery in order to achieve a better cosmetic as well as therapeutic result in patients who need removal of part of the breast or the entire breast due to a medical condition, commonly breast cancer.
Without planning breast surgery in a way that optimizes the cosmetic result, the psychological integrity of the patient is very commonly affected, causing in most cases strong states of depression and impacting self-esteem and self-image. A depressed patient is more prone to complications and therefore the necessary treatment after surgery becomes more difficult. On the other hand, today the development of oncology has made the possibility of surviving breast cancer very high.
These patients must be able to reintegrate into society and into their intimate life. From this need, oncoplastic surgery was developed, with the goal of ensuring that all patients who are going to surgery for breast cancer can enjoy the best reconstructive alternative immediately during the same oncologic surgery.
TERMINAL DUCT EXCISION:
The tissue that is just behind the nipple, where the terminal ducts are located, is removed. This surgery is indicated when there are pathologic nipple secretions, that is, secretions with blood, spontaneous, persistent, or from only one duct. Most nipple secretions are not pathologic but physiologic; in case of doubt, you should always consult a surgeon.
PARTIAL OR TOTAL MASTECTOMIES:
These are breast removals due to cancer. Depending on the location or size of the cancer, there is the option of performing a partial or total removal of the breast tissue. Oncoplastic surgery looks for the best alternative and incorporates breast reduction and/or breast lift surgery to optimize the result.
SKIN-REDUCING MASTECTOMY:
For women with sagging or large breasts, this technique is used to reduce their volume and/or raise the position of the breast.
TOTAL MASTECTOMY WITH NIPPLE PRESERVATION:
One of the most innovative surgical techniques offered by oncoplastic surgery, in which all the breast tissue is removed while preserving the breast skin and the nipple. In the same surgery, the volume that has been removed is filled with a breast implant or with tissue from the same patient, providing immediate breast reconstruction.
PROPHYLACTIC OR PREVENTIVE MASTECTOMY:
When all the breast tissue is removed to prevent breast cancer, that is, the patient has not been diagnosed with breast cancer but, in order to avoid it, all the breast tissue is removed. Mastectomy is definitely the most effective preventive option that exists, but it is not offered frequently because it is a mutilating surgery. With advances in oncoplastic surgery, total mastectomy with preservation of the skin and nipple has achieved the most optimal results in immediate breast reconstruction, so preventive mastectomy has gained momentum and is used more and more. High-risk patients are the best candidates for this surgery, for example patients with a strong family history of breast cancer; patients diagnosed with breast cancer who may opt for prophylactic mastectomy of the other breast; patients who are positive for the genetic test for breast cancer (BRCA1/BRCA2); patients with breast biopsies that show “atypia” or “lobular carcinoma in situ”; these are risk markers for breast cancer.
ONCOPLASTIC SURGERY
Fear, uncertainty, anguish. All of that generated a lot of anxiety that I tried to manage and to shield my family from, as they were just as bad or worse. Even though I sought appointments with oncologists and surgeons and listened to the professionals and what they suggested based on my diagnosis, I continued my search because I was not convinced by the proposed procedures and arguments. God places people in your path, and I had met a friend at work who was from Hatillo; his wife had been treated by Dr. Kathia V. Alejandro, oncoplastic breast surgeon, and I asked him for her contact. She was the light at the end of the tunnel. That day I had also made an appointment with Dr. Báez (RIP), and when I told him that Breast Oncoplastic Surgery – Dr. Kathia Alejandro, MD FACS was my surgeon, he told me YOU ARE IN THE BEST HANDS, and that her reconstructions are spectacular. Thanks to her procedure, she performed a mastectomy and reconstructed me in the same surgery. Thanks to God and the doctor, I did not suffer the long, painful process of a delayed reconstruction. If you are going through that difficult anguish, give yourself the opportunity and consult with her before deciding. You will not regret it.
- María Mercado -
