Surgical Treatment for Breast Cancer
The modern approach aiming for cure and quality of life
Despite advances in chemotherapy, radiotherapy and hormone therapy, the surgical treatment remains the foundation of addressing breast cancer. Removal of the initial focus of the disease is necessary to achieve a cure.
What are the goals of surgical treatment?
The surgical treatment of breast cancer aims at three main axes:
- Removal of the tumor: It can be performed by lumpectomy (conservative surgery) or mastectomy (total removal of the breast), depending on the characteristics of the lesion.
- Staging of the disease: Μέσω της Sentinel lymph node biopsy evaluates possible metastasis to the axillary lymph nodes
- Aesthetic result: By using oncoplastic techniques, the aim is to restore the image of the breast in a way that enhances the woman's physical and psychological well-being.
Lumpectomy or Mastectomy?
In today's era, the lumpectomy (removal of the part of the breast that has the lesion) is the usual choice. When combined with irradiation, offers oncological safety similar to mastectomy, with the advantage of preservation of the natural breast.
The final decision depends on:
- Tumor size and location
- Patient preference
- Need for radiotherapy or additional adjuvant therapies
Sentinel Lymph Node Biopsy or Axillary Lymph Node Dissection?
The disease staging in the armpit is decisive. In the past, the usual practice was to axillary lymph node cleaning – an invasive technique with significant potential complications (e.g. lymphedema).
Today, the sentinel lymph node technique offers a safe diagnosis with fewer side effects. Using a dye and a radioactive substance, 1-3 "sentinel" lymph nodes are identified, which are checked for malignancy. If they are negative, no additional surgery is needed. If it is positive, may require further lymph node cleaning – except in specific cases where it may be omitted, according to modern guidelines.
When Is Sentinel Node Biopsy Not Performed?
The sentinel lymph node technique is not indicated:
- Known axillary metastasis prior to surgery
- Advanced-stage disease
- Pregnancy (due to radioactive tracer use)
In these situations, direct axillary lymph node dissection is performed.
Oncoplastic Techniques – Careful Reconstruction
Oncoplastic surgery combines cancer control with aesthetic restoration. Techniques include:
- Rearranging existing breast tissue
- Placement of implants or tissue expanders under the chest muscle
- Use of autologous tissue (e.g., from abdomen or back)
Method choice depends on:
- Breast shape and size
- Tumor location and volume
- Planned radiotherapy
- Patient preference
What Is Prophylactic Mastectomy?
Prophylactic mastectomy is recommended for women without cancer but with high genetic risk—such as BRCA1/2 mutation carriers or those with strong family history. It reduces breast cancer risk by 90-95%, usually combined with breast reconstruction using implants or other techniques.
This is a deeply personal decision, made with support from a specialized multidisciplinary team including breast surgeons, oncologists, geneticists, and psychologists.
Αποτελεί μια βαθιά προσωπική απόφαση που λαμβάνεται με τη στήριξη εξειδικευμένης ομάδας: χειρουργού μαστού, ογκολόγου, γενετιστή και ψυχολόγου.
Breastaware.gr: Knowledge Is Power
At breastaware.gr you will find reliable, documented and understandable information on all issues concerning the breast cancer – from diagnosis to treatment and recovery options. Get informed, empowered and share the information with those who need it.
Scientific Sources & Guidelines
- National Comprehensive Cancer Network (NCCN) Guidelines
- European Society for Medical Oncology (ESMO) – Breast Cancer Guidelines
- American Society of Clinical Oncology (ASCO) Guidelines
- National Cancer Institute (NCI), U.S. National Institutes of Health
- American Cancer Society
- Society of Surgical Oncology (SSO) – Sentinel Node and Axillary Surgery Guidelines
- DeSantis CE, Ma J, Gaudet MM, et al. Breast cancer statistics, 2024.
- Harvard Medical School – Women's Health Watch
