Breast Surgery

If you are seen (referred) with subjective symptoms such as a lump, discharge from the nipple, breast pain, etc., or if an abnormality is pointed out during a checkup.

• Following inspection and palpation, a mammogram (3D mammography (tomosynthesis)) is taken and an ultrasound examination is performed.
• Breast MRI using a contrast agent is performed for the purpose of further increasing the accuracy of diagnostic imaging.
• To confirm the diagnosis, we perform scraping cytology, fine-needle aspiration cytology, needle biopsy under local anesthesia, and excisional biopsy.
• If mammography shows calcification and a definitive diagnosis of benign or malignant is necessary, a stereo-guided mammotom is performed.
• In some cases, we may ask you to re-examine the items that were performed before visiting our hospital.
• In some cases, a tissue diagnosis is performed by inserting a thin tube from the opening of the milk duct where secretion is coming out, injecting a dye through it, and extracting the stained part.

The size of the lump that can be treated with breast-conserving surgery is generally considered to be 3 cm or less, considering the size of the Japanese breast and the shape of the breast after resection.

The size of the lump that can be treated with breast-conserving surgery is generally considered to be 3 cm or less, considering the size of the Japanese breast and the shape of the breast after resection. In addition, even if the size is 3 cm or less, if an ulcer is formed on the skin in the same area, if the skin is discolored, or if the nipple is pulled in near the nipple and depression is observed, breast preservation is advised. Surgery is difficult. However, in some cases, such as when drug therapy is performed before surgery and therapeutic effects such as tumor shrinkage are obtained, conservative surgery may be possible.

There is a risk of cancer developing in the breast that is preserved (local recurrence). Therefore, radiotherapy is the standard treatment after conserving surgery. Local recurrence is said to be reduced to about one-third by irradiation.

Mastectomy is performed for those who are not suitable for breast-conserving surgery due to special illnesses or those who have already undergone radiation therapy, or for those who did not wish to have breast-conserving surgery. Depending on the indication, consideration will be given to cosmetology, such as a subcutaneous mastectomy that preserves the nipple and areola or a skin-sparing mastectomy.

Mastectomy is performed for those who are not suitable for breast-conserving surgery due to special illnesses or those who have already undergone radiation therapy, or for those who did not wish to have breast-conserving surgery. Depending on the indication, consideration will be given to cosmetology, such as a subcutaneous mastectomy that preserves the nipple and areola or a skin-sparing mastectomy. In principle, the pectoral muscle is preserved, but pectoral muscle joint resection may be performed as necessary, such as when cancer spreads to the pectoral muscle.

We will also talk about breast reconstruction surgery in cooperation with Plastic Surgery. There are cases in which the breast is reconstructed at the same time as the mastectomy (primary reconstruction), and in cases where it is reconstructed after a period of time (secondary reconstruction). There is a one-stage reconstruction, such as inserting an implant at the same time in one reconstruction, and a two-stage reconstruction, such as inserting a tissue expander at the time of reconstruction first to spread the skin and then replacing it with an implant. For reconstruction, autologous tissue (lattis dorsi or rectus abdominis muscle flap) or implants may be used.

The sentinel lymph nodes (sentinel lymph nodes or sentinel lymph nodes) are the few lymph nodes that are thought to be the first to spread if breast cancer spreads to the lymph nodes in the armpit. A sentinel lymph node biopsy removes a few of these lymph nodes.

The sentinel lymph nodes (sentinel lymph nodes or sentinel lymph nodes) are the few lymph nodes that are thought to be the first to spread if breast cancer spreads to the lymph nodes in the armpit. A sentinel lymph node biopsy removes a few of these lymph nodes.

Methods for finding the sentinel lymph node include injecting a radioactive isotope around the areola and injecting a dye (such as ICG). At our hospital, we use these methods to find sentinel lymph nodes. In the past, when there was metastasis in the sentinel lymph node, all the lymph nodes under the arm were removed (dissection is a technical term). Currently, even if there is metastasis in the sentinel lymph node, we select cases and omit dissection. Also, if there is no metastasis in the sentinel lymph node, dissection is omitted.

Whether there is metastasis in the sentinel lymph node is examined by rapid pathological examination during surgery or by permanent pathological examination over a period of about two weeks. This sentinel lymph node biopsy was developed with the aim of reducing sequelae after lymph node dissection, such as numbness and pain on the inside of the upper arm that increases when dissection is performed, and refractory edema in the forearm and entire upper arm.

Hormone therapy reduces estrogen, a female hormone produced in the body by using hormone treatment drugs, and reduces estrogen receptors in breast cancer (like intakes for estrogen). It interferes with the binding of estrogen to prevent cancer growth.

Hormone therapy reduces estrogen, a female hormone produced in the body by using hormone treatment drugs, and reduces estrogen receptors in breast cancer (like intakes for estrogen). It interferes with the binding of estrogen and prevents cancer growth. The purpose of this treatment is to control breast cancer cells hidden somewhere in the body after surgery and prevent recurrence. Since treatment will continue for 5 to 10 years, please fully understand the significance and side effects of hormone therapy before starting treatment.

Cancer cells have a high proliferative ability (fast growth rate), and hormone therapy alone is considered insufficient to prevent recurrence (genetic testing may be used to determine this), or hormone therapy is indicated in the first place. It is performed for those who do not have breast cancer. The goal is to prevent recurrence.

Cancer cells have a high proliferative ability (fast growth rate), and hormone therapy alone is considered insufficient to prevent recurrence (genetic testing may be used to determine this), or hormone therapy is indicated in the first place. It is performed for those who do not have breast cancer. The goal is to prevent recurrence.

Anticancer agents such as anthracyclines and taxanes are often used, but the drug is selected according to the individual patient's condition. Side effects include hair loss, malaise, loss of appetite, numbness in the hands and feet, and decreased blood counts. At our hospital, we work closely with the Oncology, chemotherapy-certified nurses, and specialist pharmacists to ensure that patients can receive chemotherapy with peace of mind.

Molecular-targeted therapy is a treatment method that targets specific molecules that are thought to be involved in the development and progression of breast cancer.

Molecular-targeted therapy is a treatment method that targets specific molecules that are thought to be involved in the development and progression of breast cancer.

Detailed characteristics of breast cancer are examined by needle biopsy before surgery and pathological diagnosis after surgery to determine whether molecular target therapy is indicated. For example, for HER2-positive breast cancer, antibodies and low-molecular-weight compounds are used as anti-HER2 treatments. Often used in combination with chemotherapy. Immune checkpoint inhibition therapy, which is cancer immunotherapy, can also be said to be a molecular target therapy in a broad sense. In addition, various molecular-targeted drugs have been developed and actually used. We will propose a treatment method that is suitable for each individual patient.