What Is a Quadrantectomy?

The choice of breast cancer surgery methods varies in different regions due to different medical conditions. In developed cities and developed regions with good medical conditions, "expanded ultra radical resection" has been completely abandoned because of its timely cooperation with postoperative comprehensive treatment. Classic Radical surgery is also less commonly used. Simple mastectomy plus axillary lymph node dissection (Auchincloss) is the most commonly used surgical method. Patey surgery, which preserves pectoralis major and pectoralis minor, is also more commonly used. Starting from the requirements of beauty and reducing psychological trauma, many people are undergoing Auchincloss surgery or Patey surgery. While primary breast reconstruction is to maintain beauty, classic radical surgery is still the main method in basic-level hospitals. Improved radical surgery is also gradually being developed. With the in-depth medical basic research, the development of prospective clinical trials and the successive reports of the results continue to impact the development of breast surgery and related disciplines; new theories, new concepts, new technologies, and make the surgical treatment of breast cancer more scientific and more Move in a reasonable direction.

Breast cancer surgery

The choice of breast cancer surgery methods varies in different regions due to different medical conditions. In developed cities and developed regions with good medical conditions, "expanded ultra radical resection" has been completely abandoned because of its timely cooperation with postoperative comprehensive treatment. Classic Radical surgery is also less commonly used. Simple mastectomy plus

The choice of surgical methods should be based on (1) clear clinical stage of breast cancer; (2) comprehensively weighing the medical conditions of patients; (3) choosing specific surgical methods that vary from person to person; the following five types of surgical methods are commonly used in China:

1. Radical mastectomy

The Halsted technique modified by Hangensen is used, that is, thin flaps, whole milk and superficial skin removal, pectoralis major, pectoralis minor, and intermuscular

1. The evolution of breast cancer surgery was originally due to the change and renewal of the concept of treatment. Advances in the research of basic theory have deepened people's understanding of the biological characteristics of breast cancer. A new concept: breast cancer is a systemic disease, replacing the concept of breast cancer as a local disease. The emergence of a large number of representative clinical randomized experimental results, the application of mammography and mammary B ultrasound, the promotion and popularization of tumor knowledge, the improvement and maturity of radiotherapy equipment and technology, the advent of new chemotherapy and endocrine drugs The application of the optimal plan and the enhancement of people's demand for breast cancer postoperative quality of life and physical beauty have promoted the improvement of the level of breast cancer treatment. The new concept of comprehensive systemic treatment, chemotherapy and quality of life replaced "local cure" The old concept of treatment has formed a treatment model that emphasizes both local and systemic treatment. Medical practice proves that comprehensive treatment can reduce the scope of surgery, improve physical effects, maintain upper limb function, and improve quality of life without affecting the survival rate and recurrence rate.

2. Comprehensive treatment is the direction of breast cancer treatment. The status of surgical "single and one" has passed. It is wrong to unilaterally promote the role of surgery and blindly worship "one knife". Clinical trials have shown that adjuvant treatment of breast cancer can reduce recurrence in one third of cases, and reduce the 10-year mortality rate by 1/6 to 1/5. The comprehensive treatment of breast-conserving surgery plus chemotherapy and chemotherapy in early breast cancer is the same as radical surgery and modified surgery in terms of local and regional control rates and long-term survival rates, but it improves the quality of life of patients. In the comprehensive treatment, it is necessary to avoid the stereotype that doctors hold their own ideas. Surgeons, radiotherapy departments, chemotherapy departments, and pathologists should pay attention to the rational design of the overall treatment plan and the organic cooperation between the therapies, and work together to ensure the success of comprehensive treatment.

3. Standard chemotherapy is the key to the success of breast cancer treatment. It should be vigorously promoted and strengthened in China. Each stage of breast cancer in Europe and the United States has corresponding comprehensive treatment guidelines (Guid line). The proposed standardization scheme is based on "Evidence-based Medicine". One of the reasons for the low level of breast cancer treatment in China is that it is not standardized. The treatment methods are extremely inconsistent, and the treatment results are quite different. There are still people doing the surgery abandoned in foreign countries, and only a few hospitals in China have carried out the technology popularized abroad. The regulation of breast cancer treatment is closely related to socioeconomic conditions, national medical facilities, and ethnicity. Breast-conserving surgery is the first choice for early breast cancer in European and American countries. However, in the American village, because some patients cannot complete all conventional treatments, surgeons do not follow the principle of breast-conserving treatment proposed by NSABP, and tend to perform total mastectomy. At the 21st San Antonio International Breast Cancer Conference and the 3rd Asian Breast Cancer Conference, Paik et al. Reported that the efficacy of breast-conserving treatment of breast cancer in Korean women was superior to that of the European-American breast-conserving treatment group. Whether breast cancer in Asian women has different characteristics from Western women remains to be studied. Breast-conserving surgery requires high medical technology, radiotherapy equipment, and treatment costs. It should not be reluctant to be carried out in some hospitals in China that do not have the necessary conditions. In short, the standardization of breast cancer treatment cannot completely replicate the treatment model in Europe and the United States, but should be formulated in accordance with China's medical resources and needs. So far, no surgery can be applied to breast cancer of various stages and locations. Therefore, while emphasizing standardized treatment, we must also follow individualized treatment principles. Under the guidance of a surgeon, breast cancer patients choose the most ideal one from different treatment options. A multidisciplinary comprehensive treatment group will play an important role in individualized treatment of breast cancer.

4. It is foreseen that in the future, there will be several types of surgery to coexist in the treatment of breast cancer, and an individualized comprehensive treatment mode that takes into account both healing and quality of life. Breast-conserving surgery plus sentinel lymph node biopsy has become the first choice for the treatment of early breast cancer in European and American countries. Since radiotherapy equipment and technology are not yet popular in China, it is only carried out in a few hospitals, but it will become a future development trend. Improved radical surgery is still dominant in China, but it will eventually be replaced by breast-conserving surgery. The completeness of the immediate breast reconstruction has been affirmed, does not affect the prognosis and follow-up of breast cancer patients, and there will be room for its development in the case of conditional hospital patient needs. Surgery can improve the local and regional control rate of breast cancer treatment and reduce the recurrence rate. Neoadjuvant chemotherapy, radiotherapy, consolidation chemotherapy, endocrine therapy, and biological therapy can further reduce recurrence and death, and improve survival. Breast cancer surgery will continuously seek its place and value in comprehensive treatment, and keep pace with the times. Detection of clinical prognostic indicators and tumor markers can help determine the strength of adjuvant therapy.

5. Japan is researching more humanized breast minimally invasive surgery, that is, large cancerous tumors are reduced by radiotherapy and chemotherapy, and then breast conservation surgery or smaller surgery is performed. These minimally invasive treatments will improve people's quality of life. The UK also reported cases of breast cancer resection with fiber endoscopy, which has brought us great encouragement and encouragement. The continuous development of minimally invasive surgery is bound to lead to a vigorous technical revolution. ^[1]