Less than whole milk Hysterectomy: In recent years, advances in radiotherapy equipment, found in early lesions than in the past and the patient’s postoperative quality of life raise the requirement, so a lot less than the total reported in the conservative surgical excision of breast . Surgically removed from the local up to l / 4 mastectomy, radiation therapy after some applications.

Breast-conserving surgery is not suitable for all breast cancer cases, and could not replace all of the radical operation, but a way of improving the treatment of breast cancer should be taken to avoid recurrence. The indications as follows: ① smaller tumor size, suitable for clinical T1 and some T2 (less than 4 cm) the following lesions; ② around the tumor, located under the areola dealers often inappropriate; ③ single lesion; ④ tumor with clear boundary such as the naked eye or microscope dealers often do not see a clear boundary is not appropriate; ⑤ axillary lymph node metastasis without clear. The effect of treatment with the following factors: ① tumor margin must have a normal border, if there is sufficient margin of normal organizers a better prognosis; ② primary tumor size and histological grade; ③ postoperative radiotherapy, surgery If no radiation therapy, local recurrence rate was high.

Random Posts

Modified radical mastectomy (modified radical mastectomy): mainly used for non-invasive cancer or invasive cancer, I of. Ⅱ clinical no axillary lymph nodes who may choose to apply.

(1) Ⅰ type: reservations pectoralis major, pectoralis minor muscle. Principle of separation of the skin incision and flap with radical surgery. Do first full mastectomy (surgical pectoralis major muscle fascia be removed), the whole side of breast to the axillary dissection, and axillary lymph node dissection, radical resection with clear basic scope. Chest diameter of God should be retained. Finally, the whole breast and axillary lymph node tissue en bloc.

(2) Ⅱ type: reservations pectoralis major, pectoralis minor muscle resection. Skin incision and other procedures were the same before the outer edge of the breast after dissociation to the pectoralis major, pectoralis major muscle to cut off the first rib attachment points 4,5,6, and turn to extend to the top of the operative field, cut off at the Department of scapula coracoid pectoralis minor muscle attachment points, the following steps with radical surgery, but should pay attention to keep the chest nerves and accompanying vessels, and finally to the whole breast, chest muscles and underarm lymph tissue of small en bloc.

Random Posts

(1) The first indications of operation Halsted radical mastectomy, because surgery is reasonable, clear effect, the treatment of breast cancer over the past century become the standard way followed. Nearly half a century, breast cancer surgical exploration for a number of changes to the trend of no more than the total expansion of both conservative and still debated. Local excision and breast milk total resection is the representation of conservative surgical procedure. Be supplemented by postoperative radiotherapy, radiation dose varies, usually 30 ~ 70Gy, the limitations of the strict selection of early cancer, you can receive a better effect. But is the conventional treatment of early breast cancer, and how to choose the accuracy of such early cancer would be difficult to draw conclusions.

(2) surgery contraindication

1. Systemic contraindications: ① tumor distant metastasis. ② frail elderly can not tolerate surgery. ③ generally poor, those who showed cachexia. ④ important organ dysfunction can not tolerate surgery.

2. Localized disease contraindications: Ⅲ patients with one of the following conditions: ① breast orange peel skin edema over half of the breast area; ② satellite nodule of breast skin; ③ violations of the chest wall breast cancer; ④ parasternal lymph nodes of clinical examination enlargement and confirmed to be transferred; ⑤ ipsilateral upper extremity edema; ⑥ supraclavicular lymph node metastasis was confirmed by pathology; ⑦ inflammatory breast cancer. The two following five situations: ① tumor ulceration; ② breast orange peel skin, edema of the entire breast area of l / 3 or less; ② carcinoma with pectoralis major fixed; ④ The maximum diameter of axillary lymph node more than 2.5cm; ⑤ axillary lymph nodes adhesion to each other or with the skin, deep tissue adhesion.

(3) surgical

1. Radical Mastectomy: 1894 and Meger Halsted radical mastectomy operation were published methods of surgical principles: ① primary tumor and regional lymph nodes should be en bloc; ② removal of all breast and major and minor pectoral muscle; ③ for axillary lymph node en bloc complete resection. Haagensen improved breast cancer surgery, emphasizing the surgical procedure should be particularly thorough, meticulous dissection flap main ①; ② flap completely separated from the chest wall will be major and minor pectoral muscle cut out flips; ③ axillary dissection chest diameter should be retained long God, such as the axillary lymph nodes were not significantly and still retain the thoracodorsal nerve; ④ chest wall defect to be skin. Intraoperative complications are: ① axillary vein injury: multi-anatomy axillary vein due to the surrounding fat and lymph tissue, the anatomy is unclear, or cut off the axillary vein, the result too close to the axillary vein. So, clearly a little exposure and keep the branch ends, is important. ② pneumothorax: the cut pectoralis major, pectoralis minor muscle in the ribs just end, sometimes for clamping small blood vessels penetrating the chest wall of the branch, the nipper too deep an extent which rendered touch broken intercostal muscle and pleura, resulting in tension pneumothorax. Postoperative complications included: ① subcutaneous fluid collection: more than skin graft fixation because of poor or inadequate drainage caused. Subcutaneous tissue and chest wall can be used between the various suture and continuous negative pressure drainage and prevention. ② skin necrosis: skin suture too tight and the skin thin and so can their causes. Skin defect is large, should adopt skin. ③ upper limb edema. Limited lifting of upper limbs: the main activity is the reduction of postoperative subcutaneous scar caused by traction. Therefore, early postoperative functional exercise required, should normally be about a month after lifting with ease the basic level can be achieved.

Random Posts

Surgery has been eight days, was particularly tight bandage Le, fluid still does not row the net, about 100ML a day or so, the head doctor put more than 20 days to arrange the net, but were very fat, this row is really fluid too painful, the other side will really worry about breast le bad, so would like to consult you how to row a little faster so fluid and nutrition it? What helps fluid discharged from eating it?

Breast fluid is a common post-operative complications were more prone to obesity. Fortunately, the body of this fluid did not affect the patient, so do not worry too much. Processing fluid commonly used suction method combined with local pressure dressing, hit some refractory fluid, individual hospital handling methods, but also more or less the same. Our experience is simply unplug the tube, then place the drainage section, daily dressing change. This of course requires the cooperation of patients, so to maintain optimism and patience is very important.

Random Posts

Intraoperative complications are: ① axillary vein injury: multi-anatomy axillary vein due to the surrounding fat and lymph tissue, the anatomy is unclear, or cut off the axillary vein, the result too close to the axillary vein. So, clearly a little exposure and keep the branch ends, is important. ② pneumothorax: the cut pectoralis major, pectoralis minor muscle in the ribs just end, sometimes for clamping small blood vessels penetrating the chest wall of the branch, the nipper too deep an extent which rendered touch broken intercostal muscle and pleura, resulting in tension pneumothorax.

Postoperative complications included: ① subcutaneous fluid collection: more than skin graft fixation because of poor or inadequate drainage caused. Subcutaneous tissue and chest wall can be used between the various suture and continuous negative pressure drainage and prevention. ② skin necrosis: skin suture too tight and the skin thin and so can their causes. Skin defect is large, should adopt skin. ③ upper limb edema. Limited lifting of upper limbs: the main activity is the reduction of postoperative subcutaneous scar caused by traction. Therefore, early postoperative functional exercise required, should normally be about a month after lifting with ease the basic level can be achieved.

2. Extended radical mastectomy in breast cancer: breast cancer, including breast cancer, extended radical mastectomy radical mastectomy or radical mastectomy and internal mammary lymph node dissection, or clear the 1-4 intercostal lymph nodes, the time required to remove the second, third and fourth costal cartilage. Surgical procedures are within the law and pleural pleural outside France, the former major trauma, complications, and they tend to use the latter.

3. Modified radical mastectomy (modified radical mastectomy): mainly used for non-invasive cancer or invasive cancer, I of. Ⅱ clinical no axillary lymph nodes who may choose to apply.

(1) Ⅰ type: reservations pectoralis major, pectoralis minor muscle. Principle of separation of the skin incision and flap with radical surgery. Do first full mastectomy (surgical pectoralis major muscle fascia be removed), the whole side of breast to the axillary dissection, and axillary lymph node dissection, radical resection with clear basic scope. Chest diameter of God should be retained. Finally, the whole breast and axillary lymph node tissue en bloc.

(2) Ⅱ type: reservations pectoralis major, pectoralis minor muscle resection. Skin incision and other procedures were the same before the outer edge of the breast after dissociation to the pectoralis major, pectoralis major muscle to cut off the first rib attachment points 4,5,6, and turn to extend to the top of the operative field, cut off at the Department of scapula coracoid pectoralis minor muscle attachment points, the following steps with radical surgery, but should pay attention to keep the chest nerves and accompanying vessels, and finally to the whole breast, chest muscles and underarm lymph tissue of small en bloc.

4. Breast surgery alone: as an old surgical resection and had been replaced by breast cancer. With the development of breast cancer biology in recent years, but mastectomy renewed attention. It is indicated: first, non-invasive or lymph node metastasis of early cases, postoperative radiotherapy can not. Second, late of breast cancer on local resection with radiotherapy alone. If the demands from the growing beauty school look mastectomy breast reconstruction is still required complex surgery. Would be unsuitable for young women in the early disease. The main indication it should be limited to age and decay or some only palliative excision of advanced cases.

5. Less than the whole milk Hysterectomy: In recent years, radiation therapy equipment because of Jin Bu discover its early lesions than in the past Yiji patients on postoperative greater demands which reports You Henduoxiaoyu all breast conservative surgical excision . Surgically removed from the local up to l / 4 mastectomy, postoperative radiotherapy.

Breast-conserving surgery is not suitable for all breast cancer cases, and could not replace all of the radical operation, but a way of improving the treatment of breast cancer should be taken to avoid recurrence. The indications as follows: ① smaller tumor size, suitable for clinical T1 and some T2 (less than 4 cm) the following lesions; ② around the tumor, located under the areola are often inappropriate; ③ single lesion; ④ tumor with clear boundary such as the naked eye or under a microscope can not see clearly the border are often not suitable; ⑤ axillary lymph node metastasis without clear. The effect of treatment with the following factors: ① tumor margin must have a normal border, if there is sufficient margin of normal organizers a better prognosis; ② primary tumor size and histological grade; ③ postoperative radiotherapy, surgery If no radiotherapy, local recurrence is higher.

Random Posts

(1) The first indications of operation Halsted radical mastectomy, because surgery is reasonable, clear effect, the treatment of breast cancer over the past century become the standard way followed. Nearly half a century, breast cancer surgical exploration for a number of changes to the trend of no more than the total expansion of both conservative and still debated. Breast excision and removal of all breast surgery is the representation of conservative surgery. Be supplemented by postoperative radiotherapy, radiation dose varies, usually 30 ~ 70Gy, the limitations of the strict selection of early cancer, you can receive a better effect. But is the conventional treatment of early breast cancer, and how to choose the accuracy of such early cancer would be difficult to draw conclusions. Fujian Provincial Hospital, China Eastern Airlines Huang basic surgical

(2) surgery contraindication

1. Systemic contraindications: ① tumor distant metastasis. ② frail elderly can not tolerate surgery. ③ generally poor, those who showed cachexia. ④ important organ dysfunction can not tolerate surgery.

2. Localized disease contraindications: Ⅲ patients with one of the following conditions: ① breast orange peel skin edema over half of the breast area; ② satellite nodule of breast skin; ③ violations of the chest wall breast cancer; ④ parasternal lymph nodes of clinical examination enlargement and confirmed to be transferred; ⑤ ipsilateral upper extremity edema; ⑥ supraclavicular lymph node metastasis was confirmed by pathology; ⑦ inflammatory breast cancer. The two following five situations: ① tumor ulceration; ② breast orange peel skin, edema of the entire breast area of l / 3 or less; ② carcinoma with pectoralis major fixed; ④ The maximum diameter of axillary lymph node more than 2.5cm; ⑤ adhesion between axillary lymph node or skin, deep tissue adhesion.

Random Posts

Once every 12 months Mammography X-ray (those who received radiotherapy after breast conserving surgery every 6 to 12 months);

Receiving tamoxifen, if they retain the uterus, once every 12 months gynecological examination;

Receiving aromatase inhibitor therapy, should be in the baseline state and after the regular monitoring of bone mineral density.

Breast cancer after standard surgery, preoperative / postoperative chemotherapy, radiotherapy and endocrine therapy, targeted therapy, some patients can achieve complete cure, in particular, a higher cure rate in patients with early stage, there are still some patients in the standard treatment, After a period of disease-free survival, recurrence and metastasis occur.

Breast cancer recurrence in patients with common metastatic sites are lymph nodes (ipsilateral clavicle and down area, the upper and lower contralateral axillary and supraclavicular region), chest wall, lungs and pleura, liver, bone, brain, these areas of concern are the follow-up condition.

Needs to be emphasized is that when breast cancer patients pain (common low back pain), we must take into account the possibility of bone metastasis, not blindly line equipment physical therapy, massage therapy, but should be a first specialist hospital for treatment, excluding bone metastases then consider other treatments, or they might speed up the development of the disease.

Recurrence and metastasis are often no symptoms initially, only on a regular basis to review the early detection, and to begin treatment as soon as possible, so that effective control of disease. Effective treatment of breast cancer means a lot, after reasonable and orderly treatment, 5-year survival rate, 10-year survival rate significantly improved, so do not give up easily in the metastasis and recurrence after treatment, or the credulity of the evaluation of non-specialist to specialist hospital receiving standard treatment is to improve the quality of life, the key to extending survival.

Random Posts

Breast reconstruction surgery has certain risks, so patients must be psychologically prepared. In general, breast reconstruction with autologous tissue transplantation surgery hours. Prosthesis implantation. Autologous tissue transplantation with the combination of three implants surgery. Selection of surgical procedure is a complex process, depending on the patient acceptance of breast implants and their own physical conditions. For example, in patients with abdominal wall relaxation. Able to provide well-organized volume, we can consider using the abdomen for the districts of autologous tissue transplantation. If the abdominal wall flat or abdominal liposuction surgery, you may consider back. Buttocks or lower extremities as a donor.

A breast reconstruction, means the removal of the breast oncologist at the same time, by a plastic surgeon for a new breast reconstruction patients. This approach avoids a second surgical trauma and breast missing psychological pressure, but can also reduce the financial burden, but its scope is relatively smaller in terms of two breast reconstruction.

2 breast reconstruction, breast surgery is the implementation of breast reconstruction after a period of time. The choice of specific time, based on the conditions and determine a patient’s own physical condition.

Studies have shown that breast reconstruction in general will not increase the risk of breast cancer recurrence.

Random Posts

Evidence-show that after the transfer of breast cancer, the patient survival rate will be significantly reduced, such as bone metastases 5-year survival rate was about 16% of the 5-year survival rate of lung metastasis was 12%, while the 5-year survival of liver metastasis rate is almost zero.

In general, breast cancer recurrence in various forms, mainly for local recurrence. Contralateral emerging and distant metastasis. The new hair is the opposite side of the mastectomy, the other side of the breast breast cancer occurred. Usually, after one side of breast cancer, contralateral breast primary risk of breast cancer will increase by 3-4 times. Refers to distant metastasis of breast cancer through blood Road to move to distant parts of the body, such as the lungs. Bones. Liver and other organs or tissue. Nearly two-thirds of breast cancer often lead to recurrence of breast cancer, distant metastasis, and distant metastasis of breast cancer death led to the greatest incentive.

Therefore, experts say, to prevent recurrence and metastasis of breast cancer five years, need to adopt a scientific approach to determine treatment options and should also encourage and support patient care and use. ATAC landmark study of 100 months, the latest data show that anastrozole reduces overall risk of breast cancer recurrence and metastasis and significantly prolong disease-free survival; even in the four years after the completion of standard therapy, its protective effect is still sustainable.

Thus, early drug use. Scientific medicine and of breast cancer patients with long-term benefits. Experts suggest that patients who meet the conditions (ie, hormone-sensitive early breast cancer patients), as soon as possible after the operation the use of appropriate drug treatment means and standard adjuvant therapy for breast cancer, endocrine program. So as to win the longer the patient’s survival time and a better quality of life. If we can take positive and effective means to reduce the recurrence risk of cancer of the road you can go 5 years, 9 years or even longer.

Random Posts

Breast-conserving cancer risk group intraoperative rapid frozen section confirmed the surgical margin was negative, with its cancer center, 1 / 4 breast tissue, together with the edge of 2 cm of skin. Thoracolumbar fascia be removed, while the ipsilateral axillary dissection lymph nodes. If the cancer is located in the Central District, the nipple can not save, then a modified radical surgery. At the same time fast-frozen section of axillary lymph nodes to check whether the transfer, if there is transfer, the possibility of a comprehensive assessment of breast-conserving, not stubbornly insist on breast-conserving. Cancer can be located outside all the mouth, if located inside or central, then the other armpit incision. Sew breast tissue as far as possible the appearance of breast, especially the nipple upright and symmetrical.

With in-depth study of molecular biology, breast cancer is considered a systemic disease, local performance, there is no fixed model of metastasis, regional lymph nodes, while having an important anti-tumor immune function, but it is not an effective barrier filtration cancer cells, blood line of the proliferation of equally important position. Thus the endless expansion of the scope of operations will not be able to improve the prognosis, but an increase of postoperative complications, to have serious implications for women’s psycho-physiological. The popularization of diagnostic techniques (including molybdenum target X line and B-), and women to medical attention, so that the rate of early diagnosis of breast cancer greatly improved, as patients become increasingly younger, increasingly strong desire to protect milk. Postoperative chemotherapy with radiotherapy and endocrine treatment of the improvement of the clinical breast-conserving surgery has laid a solid foundation, so that breast-conserving surgery in clinical practice to achieve great success. People from a purely biomedical model to the new biological – psychological – the changing pattern of social medicine to require the improvement of postoperative quality of life. Europe and the United States in many countries breast center prospective study confirms that breast-conserving surgery Ⅰ ~ Ⅱ breast cancer and improved the long-term efficacy of radical surgery for the same, but fewer postoperative complications.

Through years concluded that breast-conserving surgery for <5 cm isolation of tumor is not invaded, and pectoralis major fascia, axillary lymph node enlargement is not clear, and there is no distant metastasis. Excision of not only to achieve effective control of local tumor, and the retained breast shape with the value of beauty and function. Intraoperative conventional axillary lymph node dissection and frozen sections not only provide a basis for post-operative stages, but also a direct impact on whether to continue breast-conserving surgery is very important. Although studies have shown that the transfer of cancer cells is a disorder of the jumping metastasis, but many centers confirmed that, for the clinical stage Ⅰ ~ Ⅱ breast cancer patients still have a certain shift in terms of the rate, it is necessary to do routine cleaning before the group. The central and subscapular lymph nodes. For the sharp lymph nodes was controversial, we advocate do not have to actively deal with intraoperative lymph node if there are multiple transfers in the frozen section, then diverted to modified radical mastectomy, to give up breast-conserving and can not be simply conserving incurred the risk of residual cancer. Adjuvant treatment is generally 3 weeks after starting from the first system, radiation therapy until after the body to restore standard chemotherapy, and endocrine therapy. Because the development of breast-conserving surgery is an effective follow-up treatment, based on, there is no complete system of follow-up treatment, pure BCT did not meet the purpose of cure. Need to solemnly declare that, although breast-conserving surgery less traumatic. Quick recovery. Complication less conducive to improving the quality of life of patients, but it must be strictly controlled indications, could not insist on a complete follow-up treatment for patients not to solely breast-conserving incurred the risk of residual cancer, and even to the doctors themselves to unnecessary medical disputes left hidden.

In summary, we believe that the strict control on the basis of indications, combined with systematic and comprehensive follow-up treatment, breast-conserving surgery is conducive to improving quality of life and social interaction in patients with confidence, worthy to be popularized.

Random Posts