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Oncoplastic Breast Surgery Abu Dhabi

 

There are numerous forms of cancer-causing cells present in our bodies. One such cluster forms breast cancer. The physical, sexual, and emotional wholeness of a woman gets threatened when she undergoes a diagnosis of breast cancer. With the advancement in medical science, physicians can now commit to restoring the patient’s self-assurance and image. The field of Oncoplastic breast surgery is expanding rapidly.

 

When the treatment of oncoplastic breast surgery Abu Dhabi is combined with a multidisciplinary approach, both the physician and patient take a breath of relief as they successfully witness the results that are likely to occur.

 

There go several oncoplastic surgical approaches that require keen reviews, body habitus, desired cosmetic outcome, tumor location, and size are some of the determining approaches to be reviewed by the oncoplastic team. The circumareolar approach for segmental resection and radial ellipse segmentectomy incision are the two approaches discussed with patients for resections located anywhere in the breast.

 

Batwing incision, Hemibatwing incision, crescent mastopexy, B-flap resection, doughnut mastopexy, and the central quadrantectomy are some of the most commonly reviewed resections done to the upper and central breast. While in the case of lower breast lesions, some of the most discussed approaches are, reduction mastopexy, the triangle incision, and inframammary incision.

Doctors and surgeons who are willing to work on oncoplastic breast surgery Abu Dhabi conserving therapies are encouraged to implement these surgical techniques to seek out breast fellowships. This enhanced training is practiced under appropriate circumstances and experts can add these therapies to their skill sets.

 

A woman who has undergone the diagnosis process of breast cancer will define it as a life-changing experience. The perception of a woman’s emotional, sexual, and physical wholeness gets permanently altered. The surgical treatment of breast cancer will bring physical changes to the breast, body, and in most cases, it has been seen that the women come face to face with their mortality.

 

By the late 1900s, the optimal surgical treatment for breast cancer patients had been breast-conserving surgery. Removal of breast cancer with an adequate surgical margin along with breast maintenance that is cosmetically acceptable to the patient, are the two major goals of breast-conserving surgery. In case, cosmesis and tumor resection are unattainable, the treatment of choice that goes with or without breast reconstruction is Mastectomy. But, the truth is, most women prefer breast-conserving surgery over mastectomy.

 

Multidisciplinary Approach: -

 

Oncoplastic breast surgery Abu Dhabi is not a one-man job. It is a multidisciplinary approach to breast cancer care characterized by close collaborations among medical teams. The team consists of professionals who work together in order to achieve the best possible surgical outcome. Radiologists, medical oncologists, radiation oncologists, psychologists, genetic counselors, and breast surgeons together work to derive the best possible results.

A radiation oncologist is the one who takes the charge of adjuvant radiotherapy and patients receiving endocrine therapy or neoadjuvant chemotherapy should come in close contact with the medical oncologist. Before the surgery, it is necessary to work through the psychological well-being of the patient. The treatment planning must be facilitated through genetic counseling and psychoanalysis.

Through the collaboration between the doctor, plastic surgeon, and the patient herself, a definite approach towards the management of contralateral breast and index takes place. In a later phase, a radiologist shows off his presence to plan the lesion localization and accurate diagnostic evaluation.

 

Management of the Contralateral Breast: -

 

Mastopexy or contralateral breast reduction is used to manage and restore breast symmetry that results from Breast conservation Surgery. There are four factors that determine whether the symmetrization surgery will be performed at the time of breast conservation surgery or after it. Patient’s wish, surgeon’s interest, availability of plastic surgery expertise, and clinical setting are the four necessary factors.

Concerns regarding the potential need for re-excision and surgical margins are still in controversy for contralateral breast surgery. Even today surgeons hesitate to perform changes to breast volume, right after radiotherapy and breast edema resulting from breast or axillary surgery.

 

General Principles To Be Followed Before The Surgery: -

 

It is the responsibility of the surgeon to achieve initial success during the breast operation. The patient must be well aware that the oncoplastic breast surgery Abu Dhabi procedures may either offer her the best or last chance of achieving cosmetic success.

Oncologic outcomes are compromised due to inadequate surgical margins. An increase in breast asymmetry and the diminished aesthetic result are the adverse outcomes from breast re-excision. There are certain recommendations those the surgeons need to follow during the surgery to improve the odds of initial success. These are: -

  • Restriction of Oncoplastic Surgery to Definitive Care: -

In order to manage the diagnosed breast lesion, it is necessary to reserve definitive therapeutic uses for oncoplastic surgical procedures. Surgical excision is not required in case the patient is suffering from a benign breast condition. Minimal invasive breast biopsy techniques should be used for undiagnosed patients to avoid extensive surgery.

During the surgery process, the surgeon should be well aware of not removing excess breast tissues. This is a therapeutic form of management so matter if it’s Atypical ductal hyperplasia, radial scar, or papillary lesions, surgical excision is required for diagnosis. The potential use of oncoplastic breast surgery Abu Dhabi techniques should be anticipated before the incision placement.

 

  • Application Of Radiopaque Markers to Surgical Margins: -

The measure margin of oncoplastic breast-conserving surgery is the redistribution of the breast gland and its mobilization to reconstruct the breast mound. In order to facilitate radiation planning, subsequent mammographic surveillance, and margin re-excision, it is necessary to place the surgical margins along with multiple radiopaque tissue markers. Nearly all patients are expected to undergo infrequently re-excision and adjuvant radiotherapy. 

 

  • Use Of Multiple Bracketing Wires: -

in order to achieve desired surgical margins and defining the lesion, multiple bracketing wires are recommended. There is an increased probability for positive margins as a single wire through the center is not sufficient to hold on to the lesion and it should be avoided for large lesions.

Localizing wires should be placed on either side of the lesion, as before the insertion it is necessary to find the right locality to put the optimal wire.  In case the plan is to preserve the overlying skin, an additional wire to a lesion may also be used. Having the radiologist mark is necessary to reduce the need for excessive digging into the breast tissues.

  • Utilization Of Intraoperative Ultrasound: -

 

If a surgeon is well experienced in the interpretation and use of breast ultrasound then only the process of Intraoperative ultrasound is recommended. The worth of intraoperative ultrasound for oncoplastic surgical resection is most evident when moving toward an injury from the back part of the breast.

 

For example, in the inframammary approach, where the direct perception of the sore from the back surface of the breast dispenses with the need to locate its area dependent on skin markings or limiting wires entering the front surface of the breast. The removal of excess breast tissues can be minimized along with improved width of surgical margins, which can be achieved when intraoperative ultrasound plays its role in either way. It can be used alone or can also be fused with wire localization.

 

  • Breast MRI For Evaluation Of Disease Extent: -

In the preoperative planning of breast cancer surgery, the value for contrast-enhanced breast MRI is still under controversy. There is no such evidence that confirms that the MRI cannot alter the re-excision rate after breast-conserving surgery. At the initial stage of operation, it is quite imperative to obtain clear surgical margins that occur during breast remodeling and reshaping.

This might be the greater rationale in the case of breast MRI in oncoplastic breast surgery Abu Dhabi. By the by, the affectability of difference upgraded MRI and the potential for bogus positive discoveries require histological affirmation of MRI discoveries before changing over to mastectomy or fundamentally modifying the approach of oncoplastic.

  • Use Of Surgical Drain: -

Providing durable volumetry construction is the ultimate goal of oncoplastic surgery. This is done by redistributing the breast parenchyma. For lumpectomy patients, seroma formation transiently preserves breast contour. Large potential spaces can be found in the performance of oncoplastic surgery.

Accumulation of large seroma can be prevented by a surgical drain. In absence of surgical train, the healing process of the wound will get complicated and the recovery procedure for breast and incision will exert excessive tension.

  • Orientation Of Surgical Specimen: -

In order to ensure the quality of breast cancer care, it is essential to have an accurate orientation of the surgical specimen. It is a more important approach than in oncoplastic breast surgery Abu Dhabi. Wide re-excision of positive margins may be a necessity to accurately orient the surgical specimen. In some cases, conversion to mastectomy might be the welcome approach.

 

  • Intraoperative Pathology Consultation: -

 

The initial resection can not be overemphasized in oncoplastic surgery, because of the Importance of attaining clear surgical margins. The utilization of intraoperative pathology consultation must include consultation of gross and frozen section analysis. Specimen radiography and surgical margins must be adopted by the surgeons to lower the risk of oncologic failure. In order to ensure that the newly formed margin mirrors the entire original surgical, re-excision of the entire affected margin should be performed.

 

  • Selection Of Patient: -

 

Most of the breast cancer patients achieve resection of breast cancers. Oncoplastic surgical procedures may be used widely to develop acceptable and improved breast appearance. A surgeon’s skillset, tumor features, and the shape and size of the breast depending on choosing the best operation. The use of a myocutaneous tissue flap is omitted from the procedures. This is the skill set that remains beyond the practice of general breast surgeons.

 

Malignancy excision and complications of combined reduction mammaplasty occur in patients under 20%. Most complications like fat necrosis can be seen with smokers and obese patients. The techniques introduced thus comprise an expansive outline of the most ordinarily performed oncoplastic breast-conserving methods for advancing cancer resection and cosmesis. This outline gives a beginning stage to specialists keen on adding oncoplastic to the careful alternatives that they deal with their patients.

The process of oncoplastic surgery requires immense dedication and focus. Individuals who wish to tune in the profession of advanced breast surgery should undergo specialized training to keep up their participation in the breast fellowship program.

If you are dealing with some complications then it is wise to undergo the screening process. Oncoplastic breast surgery Abu Dhabi will take the charge to free you from the deadly cancerous cells. At Dr. Haytham’s clinic, you can easily get your treatment done. You will be under the supervision of expert minds who coordinator together to secure your future.