Breast Health is a branch of health that requires different medical specialties to work together.
Close cooperation of the radiology and breast surgery
specialist is required at the stage of diagnosis in breast diseases. The
evaluation of the radiological examinations performed at this stage and the selection
of additional examinations to be performed are only possible with the
cooperation of these two branches. In order to apply breast conserving
surgery, there should be no tumor in more than one focal
point. Radiological optimal evaluation of this situation is very important
in making the surgical decision.
Among the current treatment methods, breast conserving
treatment is the most preferred surgical approach. The choice of breast
cancer surgery is made by evaluating factors such as the stage of the disease,
the biological characteristics of the tumor, the patient’s age, and the
presence of concomitant diseases. Today, breast conserving surgery, which
is performed by removing a small amount of healthy breast tissue around it
together with the cancer tissue, is the most common method. The addition
of radiotherapy treatment to breast conserving surgery has similar treatment
success rates with removal of the entire breast. The use of these two
treatments together and appropriate patient selection is possible with a
multidisciplinary approach. With breast conserving surgery, both the
physical appearance is preserved and the psychological breakdown caused by
cancer is prevented.
Patients who do not have distant organ metastases but
have more than one lymph node metastasis in the armpit are called locally
advanced breast cancer. The current treatment approach in such breast
cancers is to suppress the tumor by first chemotherapy (neoadjuvant
chemotherapy) and then to apply surgical treatment options. Likewise, chemotherapy
can be applied before surgery to shrink the tumor and perform breast conserving
surgery in patients with large tumors compared to breast tissue, where breast
conserving surgery is not possible. Patient selection for these treatment
options is only possible with a multidisciplinary approach.
Nowadays, intraoperative radiotherapy applied during
breast conserving surgery replaces the long-lasting radiotherapy after
chemotherapy. With this approach, both the side effects of radiotherapy
are reduced and results can be obtained in a short time during surgery instead
of long and costly radiotherapy treatment. Patient selection for this type
of treatment can only be done with the cooperation of radiation oncology
specialist and breast surgeon.
Pathological evaluation after the surgical treatment of
breast cancer is very important for evaluating both chemotherapy and
radiotherapy options, number of cycles, whether hormotherapy will be applied or
not, and radiotherapy options. At the same time, it is possible to predict
the course of the tumor with the result of pathology. For this reason, all
breast cancer patients in our hospital are evaluated in the tumor council with
postoperative pathology, radiology results and examination results such as PET
tomography evaluated by the nuclear medicine clinic. The decision for
treatment can only be made in a healthy way with a multidisciplinary study
conducted in these councils.