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The risk assessment for breast disease is mostly based on family history and sometimes on genetic tests (BRCA1, BRCA2, PALB2 or TP53 gene mutation) as per international guidelines and evidence-based medicine.

 
 

Based on your personal risk profile we will discuss the best management options which can vary from minor lifestyle choices to periodic follow-up, to pharmacologic treatment,  to risk reduction surgery. During the visit, I will show you how to perform a correct breast self-examination. 

 

Breast Cancer is the most common cancer in women and can occur at all ages. One in 8 women is expected to develop breast cancer in her lifetime.

Dramatic progress has been made over the decades in the management and treatment of breast cancer, resulting in complete curative results in most cases.

The prognosis depends on many factors such as the type of breast cancer, its size and grade, the hormone receptors present in its cells, the involvement of lymph nodes, and others. 

It is important to remember that early detection is key to a positive outcome. 

 
 

If you were diagnosed with breast cancer I would discuss with you all the surgical treatment options. We would agree on the management plan taking into consideration all your questions and wishes. You may want to ponder the different options with no rush or discuss them with your relatives or friends. This is totally fine and you would be given the time to do that. 

I would tell you if surgery wasn’t the best option or maybe not the first step of the treatment; for example, chemotherapy or hormonal therapy may be the initial choice. In these cases, I would refer you to trusted specialists and we will continue looking after you as a team.

The surgical options that I can offer, depending on individual cases, vary from mastectomy to different conservative procedures (when only a part of the breast is removed) and reconstructive options to restore the body image.

 

70% of women experience breast pain (mastodynia) during the course of their life, and approximately 50% will feel one or more lumps.

In the majority of cases, these conditions are benign but a thorough assessment is necessary to ensure early detection of more serious pathologies.

If you are concerned about pain, lumps, thickening, swelling, skin dimple, rash, nipple discharge, or any other changes you should seek prompt professional advice. I can reassure you that your condition has been correctly assessed.

I will take a detailed general health and breast history, including any familiarity with breast disease, to assess your risk factors.

I will then conduct a thorough breast examination and explain which investigations are required based on your individual circumstances.

Some of the investigations commonly required are mammogram, ultrasound scan, contrast enhancement mammogram, MRI breasts and core-biopsy or fine-needle aspiration, in selected cases.

 

The aim of conservative surgery is to preserve part of the breast after complete resection of cancer. This allows to perform reconstructive surgery, when the oncoplastic breast surgeon creates a more natural breast shape using an implant, a flap of tissue from another part of your body or adipose tissue (fat) harvested from your abdomen or thighs (fat-transfer technique). 

Reconstructive surgery can be performed at the same time as the cancer excision or delayed by months or even years, depending on individual circumstances.

Breast-conserving surgery is possible when the size of the tumour in relation to the breast allows complete removal of the tumour with enough breast tissue left to be reshaped to provide good esthetic results.

Paramount is the complete removal of cancer.

 
 

Surgery is done under general anaesthetic as a day case or with an overnight stay in hospital. 

During the procedure, the cancer is removed with a rim of normal breast tissue to obtain complete eradication with clear margins. 

The residual healthy breast tissue can be shifted into the resected area in which the tumour was located, to reduce the deformity and scarring.

In some cases of large breast tumours or when the lesion is situated in certain positions, breast reduction surgical techniques are used to relocate the nipple-areola into a better position. The result is a natural shape but a smaller breast. Surgery to alter the opposite healthy breast can provide symmetry between the breasts.

When an excision of a large tumour does not allow a satisfactory cosmetic result with the approach described above, it is sometimes possible to replace the missing volume using a nearby flap of tissue or perform a mastectomy with or without immediate breast reconstruction.

 
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About us

At our clinic, we offer nourishing therapies designed to promote overall wellness and enhance your beauty.

Peter Bowman

Certified Dermatlogist