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How is non-palpable breast tumor located during surgery?

Stereotactic labeling is used in cases of non-palpable lesions. It is done through a computer system: a wire placed inside the skin (which can be guided by mammography, ultrasound or MRI) goes to the lesion, guiding the location of the affected area. The needle can be left in place for intraoperative guidance by the surgeon, or a contrast or radioactive seed is injected, which will localize the area during surgery. This modern technique is called ROLL (radio-guided location of hidden lesions) and makes it easier for patients and the surgical team. And finally, open biopsy (surgical), where an incision is made in the area where the tumor is located, being removed totally or partially. Then, the material is sent for microscopic examination.

The breast segment must be radiographed to confirm the complete removal of the lesion and to assess the margins

During surgery the nodule can be examined by the freezing method, by an experienced pathologist, and then, after surgery, by the paraffin fixation method. This second takes longer, the result is obtained in up to three days.














                                             Iodine seed to locate lesion














                                             X-ray of the lesion in the surgical piece


When is mastectomy indicated?

Breast cancer is a disease known since antiquity, but its diagnosis and treatment have been standardized for only 100 years, when Prof. Willian Halsted laid the foundations for surgical treatment. Classically, in this surgery, the entire mammary gland, pectoralis major and minor muscles are removed, associated with axillary lymphadenectomy. Later it evolved to the modified radical mastectomy to Patey, with preservation of the pectoralis major muscle, and finally the radical mastectomy to Madden, with preservation of both muscles.

Initially, cases of breast tumors were diagnosed in advanced stages and usually through self-examination. With the advent of mammography, initial and subclinical lesions were diagnosed, which allowed the development of conservative surgical techniques, with breast preservation. Mastectomy is indicated for patients who are not candidates for conservative treatment.

With a simple or total mastectomy, the entire mammary gland is removed, preserving the skin and/or the papillary areolar complex (PAC)

A radical mastectomy removes the entire breast, CAP, lymph nodes in the armpit, and the pectoralis major and minor muscles. In modified radical mastectomy, the pectoralis major muscle is preserved












Criteria for mastectomy:

- Tumor larger than 3 cm

- Multicentric tumor

- Extensive intraductal component

- Axillary involvement

- Breast cancer and pregnancy

- Impossibility of radiotherapy

- Carriers of hereditary pathogenic mutations


How is the use of drains in breast surgery?

During breast surgery, cuts, the use of an electric scalpel and suture stitches are necessary, this generates the accumulation of secretions and blood. Drains are placed to prevent fluid accumulation (seroma) and facilitate healing. In general, it is removed in up to 4 days, but major surgeries and breast reconstruction (implants, expanders) can stay for up to 15 days.

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Obrigado por enviar!

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Sorocaba Medical Center


Rua Sorocaba, 464 - room 202

Tel. 21 2537-0138 / 2539-5093

    Second fourth  it's Friday

Americas Medical City

Barra da Tijuca

Av. Jorge Curi, 550 - rooms 252/253

Tel. 21 3264-4866 / 3264-4863

    Tuesday and Thursday

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