Surgical Advances in Breast Cancer

Today, there are more treatment options available to people living with breast cancer than ever before. As well as improving outcomes for patients, these advances are improving the quality of life and overall wellbeing of women.

Surgical advances are enabling better preservation of the breast and its tissue and are minimizing scars in ways that were not possible before. In turn, these procedures are helping women to recover both physically and emotionally from their cancer journey.

These complex, state-of-the-art surgeries are both life-changing and life-saving. Available at Cleveland Clinic Abu Dhabi’s Oncology Institute, the multidisciplinary team of experts work with every patient to determine the least invasive yet most effective treatment course for every patient.

Advanced surgical techniques include:

Breast-Conserving Surgery (Lumpectomy)

A lumpectomy is surgery to remove cancer from the breast, unlike a mastectomy which removes the whole breast. The aim of a lumpectomy is to leave as much tissue in place, so the breast looks as close to how it did before surgery as possible.

Breast-conserving lumpectomies remove only the tumor and a small margin around it, preserving most of the breast. This results in a much more aesthetic outcome for women. However, if a large tumor is removed, it can affect the size and shape of the breast, resulting in asymmetry. In these cases reconstructive surgeons can help to restore the appearance of the breast (see below for further details on breast reconstruction).

Sentinel Node Biopsy

The sentinel nodes are the lymph nodes to which cancer usually spreads first, so a sentinel node biopsy is a procedure used to indicate whether cancer has spread.

In a sentinel node biopsy, tracer material helps doctors to find the sentinel nodes, which are then removed and tested for cancerous cells. If the sentinel nodes show no signs of cancer, then it is unlikely the cancer has spread, and the removal of additional lymph nodes is not necessary.

Sentinel node biopsy is an essential tool for staging cancer and aids treatment decisions.

Oncoplastic Surgery

Oncoplastic surgery is a relatively new surgical technique which involves removing breast cancer using plastic surgery techniques. The valuable approach to breast conservation aims to reconstruct the defects in the appearance of the breast that occur when cancer is removed.

During oncoplastic surgery, skilled surgeons combine the removal of a tumor, either via a lumpectomy or partial mastectomy, with advanced reconstructive techniques (plastic surgery).

The approach vastly improves cosmetic outcomes for patients and gives them confidence in knowing that their cancer has been removed whilst the appearance of their breasts has been preserved, in one surgery.

Breast Reconstruction Surgery

Thanks to advances in reconstructive surgery, surgeons can restore the shape, appearance, and symmetry of the breasts following a mastectomy, with greater aesthetic results than ever before. This is a very important part of enhancing self-image and quality of life for patients.

Reconstructive surgery can be done immediately at the time of mastectomy (complete removal of the breast) or delayed at any time after the patient finishes cancer treatment. It is also possible to reconstruct breasts after partial removal of the breast (lumpectomy).

Women can choose to recreate and rebuild the missing breast with either prosthetic reconstructions (silicone implants) or via a more complex microsurgical reconstruction technique called autologous reconstruction, which uses the patient’s own tissue to rebuild the breast.

Cleveland Clinic Abu Dhabi was one of the first centers in the UAE to offer a specific type of autologous reconstruction called the DIEP flap. Commonly using tissue from the lower abdomen, this gold standard treatment for breast reconstruction also includes secondary procedures such as fat transfer to the breast and nipple reconstruction.

Immediate lymphatic reconstruction following surgery can decrease the chance of lymphedema. Currently only performed in a handful of centers worldwide, including the Breast Health & Cancer Program, prophylactic lymphovenous anastomosis is a cutting-edge procedure which can prevent post-surgery swelling and fluid build-up in the upper extremities.

The Breast Health & Cancer Program at Cleveland Clinic Abu Dhabi provides access to a full range of breast health services, all in one place.