Plastic surgeons suggest removal after breast tumor

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oncologists, meanwhile, argue that conservative surgery as standard therapy is maintained in this type of cancer

Third change in restorative breast surgery. After 20 years extolling the bonanzas of conservative surgery that is, removing the bare minimum to neutralize tumor and to preserve as much as possible the own chest, plastic surgeons have given a twist to clinical guidelines and have claimed mastectomy (Total removal of the breast) and immediate reconstruction as an alternative on the rise. The results of conservative surgery are unexpected, eyes of plastic surgeons, According to these experts, this week met at an international conference in Sant Pau hospital in Barcelona, around the 40% of conservative surgeries do not get the expected results and determine the quality of life of patients. In the long run, many women undergoing this technique end up going back under the knife to have a mastectomy and immediate reconstruction.

Good image was fashioned conservative surgery, even converted a quality indicator, the postulated as the practice used immediately after surgery in breast cancer. Preserve the shape of the chest is a priority for more than 20 years and now, until the 70% Breast interventions opt for this technique. Oncologists defend but plastic surgeons have opened the door to assess the impact and long-term outcome of these techniques. “You have to look what the quality of life of this 70% which is subjected to conservative surgery. A French study shows that among the 30% or 40% of these women gives them poor results because eventually causes an asymmetry of shape and feel that conditions the life of the patient”, says Dr. Jaume Masià, Director of Plastic Surgery Sant Pau and host of the event.

In addition to the long-term aesthetic disorders, recurrence of a new tumor also varies, plastic surgeons say. The probability of recurrence after surgery ranges from conservative 6% and the 8% of the cases, whereas after a mastectomy is barely 2%. With everything, WARNS Masià, relapse “not only it is based on resection margins chest”, but influenced by other factors such as tumor biology itself.

In any case, plastic surgeons advocate “check” the choice of conservative surgery for mastectomies and reconstruction. The conservation, experts say, You can result in longer treatment (usually requires radiation therapy) and more controls for risk of relapse. The other technique, instead, ensure a better quality of patient because the cosmetic result is better and the risk of recurrence, less. Masià insiste, However, it is not about conservation delegate to the background, as mastectomy “Nor is it a panacea and has a few limitations and risks like any surgery”.

oncologists, meanwhile, defend the current situation. “There is no reason for sparing surgery no longer the standard”, says the oncologist Miguel Martín, the Spanish Research Group on Breast Cancer (GEICAM). “In the US it has shown that mastectomy does not increase survival and reconstruction, It sold as very good, is not always so well”, Martin points.

With the open debate and taking into account the incidence of breast cancer in Spain (detected a 20.000 new cases per year) and its impact on the lives of patients, Sant Pau experts and Hospital del Mar in Barcelona have chosen to copy their French neighbors and prepare their own study to audit the results of conservative surgeries performed in recent years.

Source: elpais.com