The diagnosis of cancer is a shock. The question of survival and, if possible, getting well again, comes first. But especially with breast cancer – every eighth woman is affected at some point – it is also about a female self-image. If a breast is cut or completely removed, this can massively change one's own and also the outer perception.
What is oncoplastic surgery?
This is where oncology starts. This is a combination of techniques from oncological, ie cancer surgery, and plastic surgery. The aim is not only to free the breast from the tumor, but also to prevent deformation by the tissue removal or immediately rebuild it completely. "With this surgical technique we can achieve a better quality of life for affected women", emphasizes surgeon Prof. Florian Fitzal, Head of the Surgical Breast Center at MedUni Vienna and expert in this method. When does she qualify and how is she used? We researched it. "Breast cancer not only removes the tumor itself, it also cuts away the tissue around it," explains Fitzal. "Up to 20 percent of the breast tissue is usually not a problem, but if it's more, you can see it." With the techniques of oncoplastics, the resulting hole is closed by tissue displacement. There is also a breast lift through a special cut from the field of plastic surgery. "The bigger the breast, the easier it can be put into practice," says the doctor. "But even with small breasts, or if a complete removal is necessary, the method is applied, then tissue from the thigh, stomach, buttocks or back is transferred or you use an implant." In any case, the aim of the technique is "that the breast is again beautiful and taut, like an earlier, younger version of itself." For the success of this method, Annemarie Burger (name changed by the editors) is the best example. Her tumor was already six inches tall, the oncoplastic cutting method was therefore a tightrope walk. During the procedure, however, it worked very well. Half a year later, the second breast was adjusted, and Burger is still happy six years later: "I have a real young girl's breasts now."
For whom is the oncoplastic method of breast cancer eligible?
Basically, says surgeon Fitzal, for every woman who needs to remove a certain amount of tissue. It is important that work is already onkoplastisch from the first OP: "If one sets the incision from the beginning accordingly, usually a very nice result succeeds Planning and experience of the surgeon are authoritative here.
Even the first breast cancer surgery should be oncoplastic
A later construction, if already lacking tissue, is much more difficult. And the surgery must take place before the radiation. "If breast-sparing surgery is required, subsequent irradiation is obligatory, but it will put a lot of strain on the tissue, so the risk of complications would be too high in post-radiotherapy operations Unfortunately, the possibility of immediate reconstruction is far too limited Fitzal knows from his daily practice that even those affected often do not think about it in the first shock, as Barbara Baier (name changed by the editors) confirms: "I had no idea what that would look like. After the surgery, I was really happy that there is a smaller, firm chest. "
Additional costs do not apply, the health insurance covers everything
Oncoplastics is a supplementary surgical training that has not yet been established on a nationwide basis and that doctors do on their own initiative. However, there is at least one doctor in each certified breast health center who works with this technique. Affected people should actively ask questions, emphasizes Fitzal. Additional costs do not apply, the health insurance covers everything. If the breast changes a lot, the second side is subsequently adjusted. This also pays the cash. Fitzal recommends the adjustment only at the end of the treatment: "Due to the healing process and the radiation, the shape of the operated breast may change, so you should wait a few months, and the result will be better."
Experience with oncoplastic surgery:
Nada Hirschbцck (52) found an early stage tumor in the left breast five years ago. She went regularly to preventative mammography from 40, among other things, because her grandmother was ill at a young age of breast cancer. An operation was necessary on both breasts, as also on the right side already first calcifications were discovered. "Since my grandmother had both breasts taken off at that time, I was naturally afraid that this could happen to me, but I could not imagine anything under an oncoplastic operation, but I was well looked after and educated at the Vienna AKH."
When, after the surgery, her sister confirmed in the recovery room that everything had gone well, a big stone fell from her heart. "My chest is relatively small, on the left you can see a slight dent, where the tissue is gone, but only if you know it, the optic has not changed significantly, and I have a very good relation to my bosom." On vacation, Annemarie Burger (56) felt a knot in her right breast. She also had a small open job, because of which she actually went to the dermatologist. He then referred them to the gynecologist, subsequently she came to the Vienna AKH. "My tumor was six centimeters tall, so first I had chemotherapy, which actually shrank the plant."
Although Burgers breasts are relatively large, oncology was a tightrope walk. The tumor was already too pronounced. But it worked well. "After surgery, I did not want to look at my chest for a couple of days, I did not feel like a woman any more, but my husband was there all the time, and my worries were unfounded." After six months, I adjusted the second page and now I'm totally happy, I have a real young girl bust. " In the spring, Barbara Baier (58) went to a screening mammogram during the screening program, when it came to the suspicion of cancer. The biopsy brought certainty. "I had many small foci that were not palpable, so screening was my salvation, but with such a diagnosis, the mammography centers will leave you pretty much alone It would be good to get support for the next steps, thank God my family doctor and friends were there for me. "
So Baier also came to Prof. Fitzal, who suggested the oncoplastic operation. "I did not even think about what that might look like, I just wanted the surgery, but in retrospect, I'm very glad there's a small, tight chest there, my breast is very big, so that was my luck Now the radiation follows, and then I think about adjusting the second page. "