Surgical Treatment BC

• What is the primary aim of breast surgery?

  To remove breast cancer and assess evidence of local spread.
• How does breast and axillary surgery improve cancer treatment?

  It allows for more accurate assessment of tumour size, biology, and nodal spread than imaging and biopsy alone.
• What is the significance of achieving disease control in breast surgery?

  It provides information to guide any adjuvant treatment.
• What is the goal of breast surgery in terms of aesthetics?

  To maintain breast cosmesis and symmetry while achieving effective oncological treatment.
• What is Breast Conserving Surgery (BCS) suitable for?

  • Patients with localized disease
  • No evidence of metastatic disease
• What is the foundation of Breast Conserving Surgery (BCS)?

  Wide local excision (WLE), which removes the breast cancer with a cuff of healthy tissue around it.
• When can Breast Conserving Surgery (BCS) be considered?

  When the size of the breast cancer is small relative to the breast size.
• What are the techniques used in Breast Conserving Surgery (BCS)?

  Techniques vary from incision placement directly over the area of disease to approaches that hide scars beneath clothing.
• What are oncoplastic techniques in breast surgery?

  They allow reshaping of the breast or transposition of local tissue flaps for optimal cosmetic outcomes while achieving oncological control.
• Why must many breast cancers be localized prior to surgery?

  To target excision accurately.
• What are the localization techniques used before breast surgery?

  Image-guided guidewire or magseed insertion.
• What does a mastectomy entail?

  Removing the entirety of the breast tissue, approximately 95% of it.
• When are mastectomies indicated?

  In cases of multifocal disease, high tumour:breast tissue ratio, disease recurrence, patient choice, or for risk-reduction.
• What are the types of mastectomies?

  Simple mastectomies, skin-sparing mastectomies (SSM), and nipple-sparing mastectomies (NSM).
• What is a risk-reducing mastectomy?

  An operation to remove healthy breast tissue to reduce the risk of developing breast cancer.
• Who is suitable for a risk-reducing mastectomy?

  Patients with a high risk of developing breast cancer.
• What factors confer risk for breast cancer?

  A strong family history of breast or ovarian cancer, testing positive for genetic mutations, or previous history of breast cancer.
• What are the two types of axillary surgery?

  • Sentinel Lymph Node Biopsy (SLNB)
  • Axillary Node Clearance (ANC)
• What is the purpose of Sentinel Lymph Node Biopsy (SLNB)?

  To assess potential lymphatic spread of breast cancer.
• How is the sentinel lymph node identified during SLNB?

  By injecting technetium-99 nanocolloid, which maps to the lymph nodes via the lymphatics.
• What methods can be used for lymph node mapping in SLNB?

  Using blue dye or solutions containing superparamagnetic iron oxide particles.
• What does Axillary Node Clearance (ANC) involve?

  Removing all nodes in the axilla to control or remove axillary disease.
• What are the risks associated with Axillary Node Clearance (ANC)?

  Paraesthesia, seroma formation, and lymphedema in the upper limb.
• What is the long thoracic nerve responsible for?

  Motor innervation of the serratus anterior muscle.
• What is oncoplastic surgery?

  • A means of reshaping breasts
  • Replacing volume with local or distant autologous tissue
  • Used for larger excisions that would otherwise result in mastectomy
• What are the types of flap reconstructive techniques?

  • Local Flap Techniques: Mobilisation of regional tissue
  • Free Flap Techniques: Harvesting tissue from another body part
• What is a Latissimus Dorsi Flap?

  A technique that involves mobilising the latissimus dorsi muscle to reconstruct the breast following mastectomy.
• What is a Deep Inferior Epigastric Perforator (DIEP) flap?

  A technique that uses tissue from the abdomen to reconstruct the breast after mastectomy.
• What is required for free flap techniques in breast reconstruction?


  Microsurgical expertise to disconnect and anastomose blood supply to chest wall vessels.