Benign Breast Surgery
Benign Breast Surgery
This surgery is often called diagnostic or excisional biopsy of a benign breast condition (commonly for fibroadenomas). It is usually performed as a day surgery under general anaesthetic in the hospital. It involves the removal of a benign breast lump. Good surgical techniques are used to achieve excellent cosmetic and functional results while removing these lumps.
Microdochectomy
Microdochectomy is a targeted operation involving the removal of a breast duct behind the nipple to help correct nipple discharge in certain cases. It is performed for suspicious nipple discharge to help treat the condition and gain a diagnosis. It is generally performed using a small incision on women who wish to preserve the ability to breastfeed after surgery.
Central breast duct excision
This operation is performed for women with nipple discharge and involves the removal of all the breast ducts behind the nipple. It is performed for suspicious nipple discharge where a diagnosis is not clear or to treat ongoing discharge. A small incision is placed around the areolar and the nipple is preserved. Breastfeeding is not possible after this surgery.
Breast reduction
Large and heavy breasts can cause physical, psychological and functional distress, known as macromastia. Women may suffer from upper back pain, neck pain, bad posture, and poor body image. This operation is offered at our clinic by Dr Sood. It involves removal of some of the breast tissue to allow for more suitable sized breasts with an emphasis on good cosmetic and functional outcome. It is performed under general anaesthetic at the hospital and involves the use of cosmetic breast surgery techniques to enhance the overall size, shape and look of the breasts.
Breast implant surgery
We offer removal of existing breast implants for reasons such as implant rupture, leaks and breast-implant related illness. This surgery involves the removal of old breast implants with capsulectomy (removal of the surrounding breast capsule) and a wash out of any leaked silicone within the breast. It is performed under general anaesthetic in a hospital often using the same previous incision on the breast. This surgery may sometimes be done in conjunction with a breast left (mastopexy) or replacement with new breast implants. Please discuss this further with Dr Sood if required.
Malign Breast Surgery
Breast Conservation Surgery (Lumpectomy)
This is performed for all those with benign breast conditions (non cancer) and majority of those with breast cancer. A mastectomy (complete removal of the breast) is not always needed for breast cancer treatment.
A lumpectomy can safely treat majority of patients with breast cancer. A range of surgical approaches such as state-of-the art oncoplastic techniques are used to safely remove the cancer and maximise the cosmetic and functional result.
Early breast cancers are often detected on screening mammogram/ultrasound before a lump can be felt in the breast. Breast conservation surgery for very small cancers that cannot be felt require a localisation technique which involve finding the small cancer prior to surgery.
Hookwire localisation
This technique involves placement of a fine guidewire on the day of surgery using mammogram or ultrasound to guide accurate placement of the wire into the cancer so that the surgeon can be guided by the wire towards the location of the cancer within the breast.
Radioactive occult lesion localisation (ROLL or SNOLL)
This technique involves injection of a small dose of radioactive tracer under ultrasound guidance into the breast cancer or abnormal breast area. This can be performed either on the day of the surgery or one day prior to surgery. During the surgery, the surgeon uses a gamma probe to detect the tiny area of radioactivity within the breast and localise the cancer (or abnormal breast area) for removal.
Most patients who have had lumpectomy for breast cancer need radiotherapy after surgery to reduce the risk of recurrence in the remaining breast tissue.
Mastectomy
A mastectomy involves removal of most of the breast. It may be the best surgery to treat certain types of breast cancers. It is also offered as a preventative operation to those with a high risk of developing breast cancer.
Breast reconstruction can be performed using implants or autologous tissue (own body fat +/- muscle) either immediately at the time of mastectomy or later on.
All women are encouraged to discuss their options for reconstruction if a mastectomy is required. Breast reconstruction is offered by our surgeons and they often do this as an immediate operation at the time of mastectomy.
The McGrath breast care nurses are actively involved in the physical and psychosocial support of all patients undergoing breast cancer surgery in our hospitals.
Sentinel Lymph Node Biopsy
This operation is performed on all patients with breast cancer. The sentinel lymph node is the first lymph node that breast cancer cells will reach if they spread beyond the breast. Identifying this lymph node and testing to see if it is involved with cancer is very important to plan further treatment after surgery.
Radioactive dye (+/- blue dye) is used on the day of the surgery to trace the location of the sentinel lymph node(s). This is often found within the armpit area using a gamma probe by the surgeon during the operation. There are usually anywhere between 1-4 sentinel lymph nodes identified. The sentinel nodes are then removed and sent for formal histopathological testing along with the removed cancer. This testing involves a detailed microscopic examination.
Patients without cancer cells in their sentinel nodes do not require further treatment to the lymph nodes such as an axillary clearance or dissection.
Axillary lymph node dissection
This operation is also known as axillary clearance. It involves the removal of most of the axillary (armpit) lymph nodes. It is sometimes needed as part of breast cancer surgery if the breast cancer cells have spread to these nodes.
About 20 - 30 lymph nodes are removed, but this does not have an adverse effect on the immune system. About 15% of patients with axillary clearance may develop arm swelling known as lymphoedema which is well managed by the lymphoedema specialists using lymphatic drainage massage techniques and a compression sleeve.
Breast Reconstruction
This operation is offered to most patients that undergo mastectomy for treatment of breast cancer or risk reduction/prevention of breast cancer. It can be performed at the same time as the mastectomy (immediate reconstruction) or at a later stage (delayed reconstruction).
Breast reconstruction can be performed using breast implants, your own tissue, or a combination of both. There are many different factors to consider when deciding about breast reconstruction. Your surgeon at our clinic will discuss these with you to help decide which option will be most suitable for you.
Breast revisional surgery
These are new state-of-the art oncoplastic techniques used mainly for the treatment of cosmetic and functional impairments following breast cancer surgery. It involves techniques such as fat grafting (lipofilling), capsulotomy for breast implants, nipple reconstruction, and implant exchange surgery.
These operations are performed mainly as day surgery under a general anaesthetic. Fat grafting is an operation which involves liposuction of abdominal/thigh fat with immediate infiltration of the treated fat cells into the area of the breast or reconstructed breast for cosmetic contouring. It is an oncoplastic surgical technique used to enhance the cosmetic and functional results from breast cancer surgery (lumpectomy or mastectomy with reconstruction). These can be discussed in more detail with your surgeon.
Nipple reconstruction is an oncoplastic technique performed to help improve cosmetic, and psychological outcomes following mastectomy and reconstruction. It is a day surgery procedure performed under general anaesthetic and may require subsequent tattooing of the areolar for enhanced results. This can be organised through our collaboration with nipple/areolar tattoo artists.