Breast surgery and reconstruction Flashcards
What are the principles of surgical oncology?
Surgical excision with a clear margin Assess surgical feasibility Assess patient suitability Assess potential impact on quality of life Preserve function MDT
What are types of breast conservation?
Lumpectomy
Wide local excision
Wire guided local excision
Oncoplastic breast conservation inc. therapeutic mammoplasty
What are types of mastectomy?
Traditional transverse
Skin sparing with immediate reconstruction
What is required for the breasts to be preserved?
Clear margins of >_1mm
Breast radiotherapy
Describe the excisions done?
Surgical wide excisions aim for 1cm excision at all margins
Full thickness excision at anterior and posterior margins
What is done for impalpable disease?
Localisation wide excison
Specimen Xray
What are types of neoadjuvant treatments?
Chemo (FEC100 and taxane +/- Herceptin)
Aromatase inhibitors e.g. tamoxifen (post menopausal women)
What is Letrozole?
Hormonal therapy
What is oncoplastic surgery?
Safe cancer surgery while avoiding tissue deformity
What conservative treatment would be offered for large breats, large tumour and reshaping?
Therapeutic mammoplasty
What conservative treatment would be offered to someone with small breasts?
Volume replacement techniques
What is a mastectomy?
Removal of all breast tissue
What are the goals of breast reconstruction?
Volume
Shape
Position (inc. nipple)
Compare to opposite breast
What 2 breast issues must be addressed in reconstruction?
Volume deficit
Skin deficit
What can be used as a pedicled flap?
Latissimus dorsi
