Sparing breast surgeries

Прим др Милош Почековац

What is a sparing surgery?

In sparing surgery the tumor is removed with the surrounding healthy tissue. How much tissue must be removed depends on the size of the tumor and where it is located. The ratio of the size of the tumor to the volume of the breast is crucial for the performance of sparing surgery.

What types of sparing surgeries are there?

The most important change in the surgical treatment of primary breast cancer was the technique of sparing breast surgery in relation to the complete removal of the breast, i.e. mastectomy, started 30 years ago. Currently, in Western Europe, 60%-80% of newly diagnosed breast cancers are treated with sparing surgery. It is sometimes called tumorectomy, partial resection or quadrantectomy depending on how much breast tissue is removed.

Are sparing breast surgeries safe?

Studies have shown that the survival rate is the same for people who have undergone minimally invasive surgery compared to a total mastectomy. The data were published between 1977 and 1981 in Milan.

The goal of the surgical technique was to remove the primary cancer and a large amount of surrounding tissue, including the skin and muscle fascia.

Later studies compared tumorectomy (tumor excision with at least 2 mm of surrounding healthy tissue) with axillary dissection and radiotherapy versus quadrantectomy with axillary dissection and radiotherapy. The overall survival rate did not differ between the two groups.

What is the advantage of sparing surgery?

Many women with early stage breast cancer can choose between breast sparing surgery and a mastectomy. The main advantage of sparing surgery is that the remaining part of the breast is retained, but most will receive radiation therapy. After a mastectomy in the early stage of breast cancer, she will not receive radiation therapy.

What are the recommendations for sparing surgery?

Sparing breast surgery is an acceptable option for the treatment of most patients with early breast cancer, with the use of oncoplastic techniques to maintain good cosmetic effects.
The ratio of the size of the tumor to the size of the breast is essential to perform a sparing operation.
Careful histological assessment of resection margins is essential. The tumor must not be on the edge of resection and it is preferable that there is > 2 mm of healthy tissue