Two situations are most commonly encountered: with indication for surgery or without indication for immediate surgery.
Therapeutic route with indication for surgery
The patient is managed by the breast surgeon who performs a tumorectomy (ablation of the tumour and a small portion of the surrounding tissue) or a mastectomy (total ablation of the breast, including areola and nipple).
The decision will be based on the size and location of the tumour as well as other parameters to be discussed between the patient and the surgeon. The type of intervention is linked to sentinel node sampling or axillary curettage.
Breast reconstruction by a plastic surgeon may also be considered, either right away – in which case the gynaecologist and the plastic surgeon work together – or subsequently. The patient’s participation in these various decisions is important.
Following the surgical operation, a more detailed patho-anatomical analysis is conducted on the tumour and the lymph nodes.
Treatment follow-up will depend on the final results of these analyses:
- either, there will be no additional treatment to be performed,
- or the following recommendations will be made:
- chemotherapy and/or to reduce the risk of remote recurrences (in such cases, this is referred to as adjuvant chemotherapy),
- radiotherapy to limit the risk of local recurrence (especially after the tumorectomy) or
- hormone therapy if the tumour has hormone-sensitive receptors .
On the day after your surgical operation, you will be seen by the psychologist. Notification of a cancer diagnosis and the various stages of treatment can be sources of disruption, raise questions and cause reorganisation of your daily life. The psychologist will listen to you without judging you and will conform to your needs free of charge. You can contact her again, if need be, for yourself or for your family circle up to six months after your treatments have ended.
Therapeutic path without indication for immediate surgery
We offer first-line chemotherapy treatment. This chemotherapy can be used to reduce tumour volume so as to avoid total ablation of the breast subsequently (in such a case referred to as neo-adjuvant chemotherapy). This becomes a formal indication in inflammatory breast cancer.
Chemotherapy, hormone therapy and radiotherapy can also be recommended for treating remote metastases.