“I was diagnosed with infiltrating ductal carcinoma in the left upper quadrant and was offered a mastectomy due to the size of the tumor relative to my breast (one size earlier). I would instead be oriented towards quadrantectomy and subsequent lipofilling at the in order not to have to empty my breasts and have to put my hand on the other to create symmetry. Is this technique provided by the health system or is it only paid for through cosmetic surgery? “
Doctor replies Andrea Sagona, breast surgeon at the Breast Unit of the Humanitas Cancer Center (Rozzano)
Dear Reader,
as you imagine, it is not possible to give personal medical opinions online, without a clinical view and an evaluation of the exams. Conservative surgery is performed in 70% of cases, when the ratio between tumor volume and breast size allows it. In the presence of tumors of increased size, multicentric lesions, extensive microcalcifications or breast of reduced volume, mastectomy, especially if performed with the nipple sparing technique (with incision from the mammary sulcus), may also represent the most aesthetically indicated choice, and is not said that it is necessary to retouch the contralateral breast.
Lipofilling allows to improve, in some cases, volume and shape deficits, when conservative surgery is performed. However, this cannot perform “miracles”, because a portion of what is injected tends to be reabsorbed and therefore the procedure must be repeated several times. Another problem is represented by the quantity of fat that can be taken: very thin patients have little fat to suck.
Sometimes, if the biological characteristics of the tumor make it indicated (e.g. HER 2 positive tumors or triple negative tumors), preoperative medical therapy can lead to a reduction in the size of the tumor and therefore allow conservative surgery even starting from a tumor volume ratio. / unfavorable breast volume for conservative surgery.
Lipofilling is also intended for use by the healthcare system
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