Breast cancer surgery

Breast cancer unfortunately continues to grow and now affects every 8th woman in Switzerland. Even if it is a shock for every woman and her relatives to receive the diagnosis "breast cancer", the good news is that breast cancer can be cured in over 90% of cases (also due to correct breast cancer surgery).
 

Early detection of breast cancer

Mammography is still the best method to detect breast cancer early. Early detection, which is recommended in Switzerland every 2 years from the age of 50, cannot prevent breast cancer, but treatment is often easier and less aggressive (minor breast cancer surgery, no or milder chemotherapy) if the malignant tumor or its precursors can be detected early.
 

Diagnosis of breast cancer

A breast cancer operation is always preceded by a precise clarification. By means of ultrasound (less frequently by mammography or magnetic resonance imaging) and biopsy of suspicious lumps in the doctor's office, it is first determined whether it is a benign change, a precursor of breast cancer (so-called DCIS) or a breast cancer. This is followed by further investigations including mammography, possibly MRI. The aim is to determine how large the suspicious area is, whether it is the only one, and whether the opposite side is free of suspicious areas. PET-CT can be used to detect evidence of offshoots of breast cancer, known as metastases.
 

Tumor board before breast cancer surgery

Before the actual breast cancer operation takes place, each individual case is discussed at the so-called tumor board. The breast surgeon, the radiologist, the oncologist, the pathologist and the plastic surgeon are present at this meeting. The goal is to determine the best individual strategy for a safe and moderate therapy or breast cancer surgery and to propose it to the affected woman.
 

Cooperation in breast cancer surgery

In order to perform breast cancer surgery with a high standard, we cooperate with the Breast Center Zurich (www.brust-zentrum.ch/ueber-uns), of which we are a member of the medical network.
 

Where the breast cancer surgery is performed

We usually operate at the Hirslanden Clinic or the Pyramide Clinic on the lake in Zurich. At both clinics we have the most modern equipment for performing the surgery.
 

Preparation for breast cancer surgery

In addition to safe breast cancer surgery, it is always a major goal to achieve the best possible cosmetic result. In the case of smaller tumors, this is usually possible without plastic surgery. However, the plastic surgeon is often involved in the preliminary stages. If it is necessary from a medical point of view to remove the entire mammary gland, various options are available today to perform a breast reconstruction in the same session - i.e. directly after the actual breast cancer operation. 

Today, the defect is increasingly performed by transplanting a fat flap from the abdomen or buttocks. This method has the advantage over the previously most used method with transplantation of a muscle flap, that the tissue has very similar properties to the real breast tissue and does not leave a muscle deficit elsewhere. Depending on the size of the breast, silicone prostheses can also be a good solution. 

Procedure of the breast cancer operation

Before the actual operation, a radioactive substance is injected into the breast, which then accumulates in the so-called gatekeeper lymph node or sentinel lymph node in the armpit and can be located during the operation using a Geiger counter. 

The operation takes place under general anesthesia. 

In the case of individual tumors to be removed, they are marked in the operating room before surgery using fine wire under ultrasound vision. This makes it easier for the surgeon to locate the tumor intraoperatively and remove it with a safe distance. If the defect is relatively large in relation to the remaining breast, a so-called "oncoplastic operation" can also be performed by spreading the remaining glandular tissue over the entire breast.
Now the sentinel lymph node is visited in the axilla and removed for histological examination.
 

After breast cancer surgery

Normally, after breast cancer surgery, one is in the hospital for 2-3 days. The arm of the affected side may and should be used normally, but without much force. A first scar check takes place in the office about 7-10 days after the surgery.

The removed tissue is examined in detail by the pathologist. After the histological findings are known (this can take up to a week for special examinations), the patient is presented again at the tumor board to discuss the further individualized procedure.
 

Aftercare breast cancer surgery

Follow-up care takes place every 3 months for the next few years, alternately with us and with the oncologist.