The principle aim of breast cancer surgery is to remove all cancer from the breast and where possible preserve the unaffected breast tissue.
Surgery has been very effective at doing this and it is the best treatment option for the vast majority of patients. However most patients will receive other treatments such as radiotherapy, chemotherapy and/or endocrine therapy to maximize their chances of cure. Surgery helps to tailor these treatments by providing additional information from the pathological analysis of the cancer tissue removed.
The second aim of breast cancer surgery is to leave an acceptable cosmetic outcome, which can impact on the patient’s quality of life. As such, oncoplastic and immediate reconstructive surgery has evolved in the last decade to optimize the success rate of breast cancer surgery in treating the cancer and leaving an acceptable appearance.
Dr Noushi performs a wide range of breast cancer and reconstructive surgeries to achieve these goals.
Hook-wire Assisted Breast Surgery:
This involves the surgical excision of small breast cancers or abnormalities that are only visible on breast imaging and not clinically palpable (felt by ones fingers). Prior to surgery the patient will undergo localisation of the abnormality by a radiologist using either an ultrasound or mammography.
Once the Radiologist has identified the area of concern, he will place a fine hook-wire into the breast under local anaesthesia. This is done on the day of the planned breast surgery to allow Dr Noushi to accurately identify and excise the impalpable breast lesion. This complex procedure improves the accuracy of surgical excision and preservation of unaffected breast tissue.
Breast Conserving Surgery & Oncoplastic Breast Surgery:
Breast conserving surgery incorporates a range of surgical procedures that Dr Noushi offers to his breast cancer patients. The majority of breast cancer patients present early in their diagnosis and in most instances the breast can be preserved. No longer do surgeons routinely perform mastectomy to excise small cancers.
Dr Noushi also performs breast conserving surgery for large cancers using new techniques of oncoplastic surgery. This type of surgery is essentially the fusion of breast cancer surgery with cosmetic plastic surgery to preserve and reconstruct the breast into a normal shape after the removal of large breast cancers.
Mastectomy is the surgical removal of the entire breast. There are several options and different types of mastectomy performed and this depends on whether a breast reconstruction is being performed at the same time.
Lymph Node Surgery:
Breast cancer surgery requires the removal of some or all lymph nodes from the armpit (axilla). Removal of these cancerous nodes provides adequate treatment to the axilla and is also important to identify patients that may require other treatment such as radiation and/or chemotherapy.
Lymph node surgery for breast cancer has undergone a major revolution. Previously patients routinely underwent a complete axillary node clearance (removal of all the axillary lymph nodes). This resulted in many unnecessary complications in patients that did not have spread of breast cancer to these lymph nodes. Dr Noushi performs limited lymph node sampling (Sentinel node biopsy) and axillary clearances (complete removal of all axillary lymph nodes) if there is evidence of cancer spread (metastases).
Dr Noushi offers a wide range of breast reconstruction options which include local breast and tissue flaps to close large breast defects (oncoplastic surgery) and implant reconstruction, both immediate and delayed reconstruction for cancer patients. Dr Noushi also works closely with several specialised plastic surgeons that perform complex breast reconstructions.