Breast Surgery

KEY FIGURES

CLINICAL SERVICES:

• Breast Cancer
• Benign Breast Diseases
• Axillary Surgery
• Neoadjuvant treatment
• Oncoplastic breast surgery

PROCEDURES PERFORMED PER YEAR:

• 575 surgical procedures

The Breast Surgery Unit aims to provide better-quality treatment by taking care of the person as a whole. Thus, it operates in a multidisciplinary manner, with a certified team of professionals that cover all the aspects of breast cancer diagnosis and treatment. Psychological support is always available for those who need it, and the ‘Salute allo Specchio’ or ‘Health in the Mirror’ project is dedicated towards female cancer patients, helping them rediscover their smile and self-confidence.

The clinical and psychological support continues even after treatment, with regular check-ups, recommendations on lifestyle, diet and physical activity.

The Unit also offers to patients the opportunity to participate in new study trials and projects as it is firmly believed in the philosophy that research represents an opportunity to improve treatment options as well as the understanding of the disease.

TREATMENTS

Breast Cancer in Women

The Breast Surgery Unit of Ospedale San Raffaele is recognized for its expertise in diagnosis and treatment of breast cancer. Remarkable skills and experience, alongside with the access to the latest breast cancer research findings and innovative treatment approaches, guarantee the best care possible. The aim of the Unit is to take care of patients with breast cancer, paying attention to the patient’s overall wellbeing, together with an entire team of experts who are fully dedicated to the breast cancer care (specialists in oncology, radiology, radiotherapy, nuclear medicine, pathology, plastic and reconstructive surgery, physiotherapy, oncogenetics, psychology).

A comprehensive multidisciplinary breast cancer approach entails preoperative and postoperative meetings, dealing with all the aspects of diagnosis and treatment, prevention, high-risk and strong family history in patient’s management.

Main Procedures:

Breast Conserving Surgery

Whenever possible, breast conserving surgery is the first choice in treating breast cancer. All procedures are minimally invasive and can be carried out in a Day-Surgery setting, with patients discharged on the same day of the surgery. Non-palpable lesions can be localised through a radioactive tracer and be removed by performing a small volume resection.

Axillary Surgery

Axillary surgery is always a standard of care in the early breast cancer. The Unit tends to avoid axillary dissection, when possible, and, following the most recent guidelines, it is starting to introduce the neoadjuvant treatment and include patients in international multi-centric randomised trials.

Oncoplastic surgery, mastectomy and reconstruction

A joined team of breast surgical oncologists and reconstructive surgeons, has an expertise in applying all techniques of oncoplastic breast surgery, pushing the surgical limits of breast-conserving surgery as well as conservative mastectomies with immediate or delayed breast reconstruction.

Neoadjuvant Treatments

Neoadjuvant treatments are offered in order to downstage both axillary and breast disease alongside with reducing surgery for both districts.

Breast Cancer in Young, and/or Pregnant Women

During the years the Unit has developed a particular expertise in treating patients of young age and pregnant women, as well as in monitoring high-risk patients.

In younger women cases, which is a very difficult and emotionally stressful area, the Unit is always trying to perform breast conserving surgery and offers all fertile women oocyte cryopreservation in collaboration with the Gynaecology Unit.

The Unit also has a special expertise in managing breast cancer during pregnancy, offering all surgical and oncological alternatives aiming at reaching the best maternal and foetal outcomes.

HighRisk Patients Screening and Treatments

Risk-reducing surgeries, screening and follow-up in women with genetic or familial breast cancer are available. When indicated, bilateral risk-reducing surgery can be performed by the surgeons.

Breast Cancer in Men

The Unit has great expertise in treating men with breast cancer, all cases are discussed in a multidisciplinary setting in order to grant the best surgical and adjuvant treatment. Genetic testing and periodic follow-up are arranged according to the most updated guidelines.

Benign Breast Diseases

The Unit is dedicated to the full spectrum of breast diseases, it deals with:

• benign tumours
• inflammatory disease
• abscesses during or out of pregnancy or lactation
• atypical lesions of the breast
• nipple discharge

Conservative treatment and/or close follow-up is offered to patients as the first choice. In case of suspicious lesions, fine needle cytology or core biopsy are performed at the same hospital, and eventually, in more complex cases, a surgery can be suggested. 

 

NOTABLE ADVANCED TECHNOLOGICAL EQUIPMENT

• ROLL Radio-guided Occult Lesion Localisation to localise non-palpable lesions
• Sentinel node Localisation through Tclabelled albumin nanocolloid
• Wireless gamma probe for intraoperative detection of sentinel node and nonpalpable lesions
• Intraoperative assessment of surgical margins
• Intraoperative frozen section for sentinel node or breast lesions
• Intraoperative sample Xray or US
• Last generation acellular dermal matrices for breast reconstruction in irradiated tissues