Les innovations dans la prise en charge chirurgicale de la tumeur mammaire
Seance of wednesday 08 november 2023 (Sénologie)
DOI number : 10.26299/9w42-tm88/emem.2023.31.01
Abstract
For over a century, surgical management of breast tumors has been evolving, with increasingly innovative and less invasive techniques.
Initially, the management of breast cancer was based on a "mechanistic" theory, but when it became clear that local and distant relapses occurred, modified mastectomies were proposed. The development of therapeutics in the 1950s and 60s, with the advent of external radiotherapy, led to a major change in tumor management, enabling conservative treatment of the breast. However, many aesthetic after-effects have been observed. Oncoplastic surgery was born at the end of the 90s to remedy this situation.
Other developments are emerging, such as the recent use of intratumoral magnetic clips for pre-operative tumor location, eliminating the need for metal wires. Another obvious example of therapeutic progress is the "one-day" treatment of breast cancer, with the possibility of intra-operative radiotherapy when the indication allows. Finally, although there are still 30% of indications for radical treatment, i.e. mastectomy, in France, a range of surgical techniques can be offered for reconstruction, from prostheses to various pedicled or non-pedicled flaps. When indications allow, this reconstruction can be proposed immediately, thus avoiding the flat hemi-thorax.
Initially, the management of breast cancer was based on a "mechanistic" theory, but when it became clear that local and distant relapses occurred, modified mastectomies were proposed. The development of therapeutics in the 1950s and 60s, with the advent of external radiotherapy, led to a major change in tumor management, enabling conservative treatment of the breast. However, many aesthetic after-effects have been observed. Oncoplastic surgery was born at the end of the 90s to remedy this situation.
Other developments are emerging, such as the recent use of intratumoral magnetic clips for pre-operative tumor location, eliminating the need for metal wires. Another obvious example of therapeutic progress is the "one-day" treatment of breast cancer, with the possibility of intra-operative radiotherapy when the indication allows. Finally, although there are still 30% of indications for radical treatment, i.e. mastectomy, in France, a range of surgical techniques can be offered for reconstruction, from prostheses to various pedicled or non-pedicled flaps. When indications allow, this reconstruction can be proposed immediately, thus avoiding the flat hemi-thorax.