Depending on tumor size and its relation to the size of the breast, the distance to the skin and the nipple, breast cancer surgery can be performed either breast conserving or by mastectomy.
In more than 80% of breast cancer cases breast conserving surgery is the method of choice and can be performed leaving nearly invisible scars without breast deformation using different oncoplastic techniques.
Mastectomies- if oncologically indicated or in the case of hereditary breast cancer- can be performed skin and/or nipple sparing with immediate breast reconstruction.
In those cases where the skin and/or the nipple is involved, a modified radical mastectomy is indicated and can be combined with an immediate reconstruction using for example an expander.
Axillary surgery is another key element in oncological breast surgery: In the case of radiologically and clinically negative axillary lymph nodes, a Sentinel-node-biopsy using blue dye and/or radionuclid is performed. During the operation the pathologist examines the Sentinel using frozen section. In case of a positive (involved) Sentinel is, more axillary lymph nodes have to be removed.