The importance of early diagnosis in breast cancer.

Breast cancer is the most common cancer in women worldwide. In Türkiye, approximately 30,000 new cases of breast cancer are diagnosed each year. Fortunately, breast cancer can be successfully treated when detected early. Therefore, raising awareness about breast cancer and encouraging women to seek early diagnosis is crucial for early detection.

The importance of early diagnosis in breast cancer:

When breast cancer is diagnosed at an early stage, the success rate of treatment is quite high. Early-stage breast cancers have a cure rate of up to 90%. However, as the cancer progresses, it becomes more difficult to treat and the chance of recovery decreases.

How is early diagnosis achieved?

There are three main methods for early detection of breast cancer:

1. Self-breast examination: It is important to examine your breasts regularly each month. During the examination, you should check for any lumps, hardness, discoloration, or discharge.
2. Doctor’s examination: It’s also important to have a breast exam with your doctor once a year. Your doctor will examine your breasts manually and check for any abnormalities.
3. Mammography: Mammography is the most effective method for early detection of breast cancer. It is recommended to have a mammogram every year starting at age 40. Mammography is an X-ray imaging of the breast tissue. This method helps in the early diagnosis of breast cancer.

Risk factors:

The risk of breast cancer can be affected by many factors. These factors include:

• The risk of breast cancer increases with age.
• Having a family history of breast cancer increases the risk.
• Genetically, BRCA1 and BRCA2 gene mutations significantly increase the risk of breast cancer.
• Early menstruation or late menopause increases the risk of breast cancer.
• Not having given birth or having the first child after the age of 30.
• Long-term hormone therapy
• Overweight or obesity
• Alcohol use
• Smoking

Symptoms of breast cancer:

Breast cancer doesn’t always have symptoms. However, it’s important to see a doctor if you notice any of the following symptoms:

• Swelling or lump in the breast
• Discoloration or rash of the breast skin
• Scaling or sores on the nipple
• Bloody or purulent discharge from the nipple
• Changes in breast size or shape
• Indentation or retraction of the breast skin
• Pain in the breast or armpit

After diagnosis:

After being diagnosed with breast cancer, your doctor will perform various tests to determine the stage and type of cancer. A treatment plan will be determined based on the results of these tests. Different methods can be used in breast cancer treatment, including surgery, chemotherapy, radiotherapy, and hormone therapy.

Surgical treatments and the role of plastic surgery:

Surgery plays a crucial role in breast cancer treatment. Plastic surgeons perform various aesthetic procedures to correct deformities resulting from breast cancer treatment and help patients regain their self-confidence.

Surgical methods:

Mastectomy is a surgical procedure in which all or part of the breast tissue is removed. Types of mastectomy generally vary depending on how much breast tissue is removed and how the operation is performed. The type of mastectomy is evaluated and performed by oncologists and plastic surgeons depending on the patient’s condition and the treatment goal. Each procedure has advantages and disadvantages, so patients should discuss treatment options with their doctor and determine which is most suitable.

Common types of mastectomy:

• Partial mastectomy: In this type of mastectomy, only a portion of the breast tissue is removed. Not the entire breast tissue is removed; only the tumor and the surrounding healthy tissue are taken out. It is sometimes also called a lumpectomy or partial mastectomy.
• Subtotal mastectomy (segmental mastectomy)In this procedure, a portion of the breast tissue, along with the tumor and surrounding healthy tissue, is removed. Less tissue is removed compared to a total mastectomy.
• Total mastectomy: In this procedure, breast tissue, nipples (areola and nipple), and sometimes lymph nodes are removed. This can be done as a treatment for breast cancer or as a preventative measure in women at high risk.
• Bilateral mastectomy: It is a procedure in which both breasts are removed. Both healthy and cancerous breast tissue are removed. Some women may choose bilateral mastectomy to reduce their risk of breast cancer.
• Bilateral prophylactic mastectomy: This is a procedure in which healthy breast tissue is removed. It may be preferred by high-risk individuals, such as women at high risk of breast cancer or those carrying a BRCA gene mutation.

Breast (reconstruction) surgery:

Breast reshaping is a surgical procedure that reshapes the breasts. It can be done using silicone implants or the patient’s own tissue.

Stages of breast (reconstruction) surgery:

• Simultaneous reconstruction (breast repair): This is reconstruction performed simultaneously with breast cancer surgery. It allows the patient to complete both cancer treatment and breast aesthetics in a single operation.
• Delayed reconstruction (breast repair): This is reconstruction performed after breast cancer treatment is completed. It is planned taking into account the patient’s general condition and response to treatment.

Two main methods are used to regenerate breast tissue:

Silicone implants: Silicone implants, produced in various sizes and shapes, are widely used for breast reconstruction. The type and size of the implant are chosen according to the patient’s anatomy and preferences.

Body tissues: Breast reconstruction can also be performed using tissues taken from the abdomen, back, or buttocks. This method is called “autologous tissue reconstruction.” Reconstruction using one’s own tissue can provide a more natural look.

Advantages of simultaneous breast reconstruction:

Simultaneous breast reconstruction is breast reconstruction performed at the same time as breast cancer surgery. This method has several advantages:

• One surgery: The patient completes both cancer treatment and breast aesthetic surgery in a single operation. This shortens the anesthesia and recovery process.
• Rapid psychological recovery: The patient’s adaptation to breast loss is facilitated, and the psychological recovery process is accelerated.
• Body image is protected: Body image disorders resulting from breast loss are prevented, and the patient’s self-confidence increases.

Simultaneous reconstruction may not be suitable for every patient. The suitability decision is made by evaluating factors such as the patient’s overall health, the stage and type of cancer.

Psychological support:

Psychological support is also important for women diagnosed with breast cancer. They may experience many emotional changes during and after cancer treatment. These emotional changes can include feelings such as fear, anxiety, sadness, anger, and loneliness. Psychological support is crucial for coping with these emotions and improving their quality of life.

Conclusion:

Breast cancer is a treatable disease when detected early. Therefore, raising awareness about breast cancer and encouraging women to seek early diagnosis is crucial. Self-examination, doctor’s examination, and mammography are the most important methods for early detection of breast cancer. Breast reconstruction, the process of rebuilding a breast that has been removed during or after breast cancer treatment, plays a significant role in improving patients’ quality of life and helping them to reconnect with life.

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In which patients is breast reconstruction using the patient’s own tissue preferred?