Lumpectomy – breast tumor removal in Israel

Here you can find information about lumpectomy or breast tumor removal surgery in Israel, as well as information about the leading surgeons performing this procedure in Israel.

You will get answers to questions such as:

how long does the lumpectomy procedure and stay in Israel take?
in which hospital do leading surgeons operate?
what is the cost of the lumpectomy and stay in Israel?
how breast tumor removal surgery goes, step by step?
what is needed after the surgery?

Lumpectomy, or partial breast removal, is one of the BCT (Breast Conserving Treatment) techniques as during the procedure only the tumor itself is being removed, not the breast.

The second important technique of BCT breast-conserving treatment is quadrantectomy – removal of the breast quadrant. The extent of the operation depends on the location of the tumor and its spread to nearby tissues.

Partial treatment, namely lumpectomy or quadrantectomy, is possible when the tumor is located in a specific area of the breast and is not multifocal or diffuse in other organs.

In order to determine the size, timing and cost of the surgery, it is necessary to consult an experienced Israeli doctor. We cooperate with surgeons who are among the five leaders in performing lumpectomy or quadranthectomy in Israel and who according to the international publication Forbes for several years have been included in the list of the best doctors in the world.

Precancer conditions and lesions - diagnostics and treatment in Israel

⇒ Leading Israeli surgeons for breast tumor removal and treatment

Based on the results of a preliminary consultation, which can be arranged online, the doctor will determine the size, timing and hospital where the lumpectomy will be performed. Most of the operations doctors carry out in the Assuta Hospital, which is equipped according to world standards, and also has a high level service in Israel.

We will coordinate the operation even before your arrival in Israel. As a rule, the operation is performed within the next few days after the consultation. We will prepare and organize all the bureaucratic issues in the hospital before the treatment.

Upon arrival in Israel, you will meet with a doctor so that he will conduct a personal examination and perform other diagnostics, including an ultrasound of the mammary glands to confirm or clarify the diagnosis and the size of the operation.

How is lumpectomy performed in Israel?

The operation involves removing the breast tumor and tissue around the tumor. Lymph nodes are part of the body’s defense system against infections, and in the case of a breast tumor, lymph flow usually goes to the glands in the armpit. To avoid spreading the disease, the lymph nodes are also removed. This is s part of breast cancer treatment.

Lumpectomy or quadranthectomy is performed under general anesthesia. A day before the surgery you will have to undergo preoperative tests which takes about 2-3 hours and include specific blood tests, cardiogram (sometimes chest X-ray) and anesthesiologist consultation. Preoperative tests will be coordinated before your arrival in Israel.

The duration of the breast tumor removal surgery varies and ranges from forty minutes to two hours.

During the operation, Israeli surgeons use a new technology called Marginprobe®, which allows to distinguish tumor tissue from normal tissue with a high degree accuracy. The surgeon measures the margin of the tumor with the device, and can perform an immediate widening of the margin, thus avoiding the need for a wide resection. The device was recently approved by the US Food and Drug Administration (FDA) and is being used for treatment in some medical centers in the country in accordance with hospital policy.

Recovery after lumpectomy

At the end of the surgery, you will be placed in a room adjacent to the operating room for observation and recovery. The duration of stay in the department is about two hours. As part of your follow-up, the medical team will monitor your condition, including your heart rate, warmth, blood pressure, oxygen saturation, pain intensity, and more. In addition, medical personnel will help prevent and relieve pain, nausea or vomiting if it occurs.

Hospitalization

Hospitalization for lumpectomy usually involves 1 to 2 nights, at the surgeon’s instruction. A nurse will monitor your condition in the department. You will continue to receive fluids until you gradually start drinking and eating normal food.

In some cases, during a breast tumor removal surgery a surgical trocar is inserted, which is a flexible silicone drainage tube to prevent fluid from accumulating under the skin.

Depending on your condition and doctor’s approval, you can get out of bed under the supervision of the therapy team on the day of surgery or after surgery. Early mobility is important for recovery from surgery and to prevent complications that may arise from prolonged lying. You can take shower 24 to 72 hours after surgery.

Breast plastic surgery after lumpectomy

Plastic surgery is part of breast-conserving surgery and breast cancer treatment. In this case, oncological considerations are combined with aesthetic ones. Breast cancer treatment takes a multi-system approach, involving doctors from different medical fields, even at the stage when the disease has just been diagnosed.

Oncology, imaging and plastic surgery are involved in the planning of the plastic surgery in Israel to ensure effective treatment of the disease with maximum consideration of the aesthetic side. The plastic technique corrects the defect resulting from the removal of tumor tissue by using the remaining breast tissue to shape it. The method may involve the use of implants.

Using this method usually results in a lift or reduction of the operated breast, and therefore it will also be necessary to “fit” the healthy breast to the operated breast, either simultaneously or as part of a separate operation. A significant advantage of plastic surgery in Israel done by an experienced Israel surgeons is the ability to remove a malignant tumor with wide and clean margins and achieve a good aesthetic result of the operated breast, as well as good symmetry with the other breast. This method is especially suitable in cases where a wide resection is required in relation to the size of the breast.

All issues of plastic surgery will be discussed during the preoperative consultation with the surgeon.

Breast reconstruction

Some women choose to live with a surgical scar and use an artificial breast (prosthesis). Others prefer reconstruction of a damaged breast. The decision to undergo reconstructive surgery is usually driven by motives related to the personal feelings of the woman and / or her partner.

Nipple and areola reconstruction

It is possible to reconstruct the nipple and the areola (dark pigment circle around the nipple). Much of this process occurs later when the reconstructed breast takes on its final shape. Thus, you can determine the most accurate position of the nipple and its correspondence to the nipple of a healthy breast. The doctor usually suggests waiting about three months before repairing the nipples. Nipples can be repaired in different ways, for example, using reconstructed breast skin, part of the nipple of a healthy breast, skin behind the ear, etc.

Biological sheet

The biological material is a special sheet (Acellular Dermal Matrix – ADM), which is based on human tissue that has been processed and cleaned by cells, therefore it contains all the components of biological skin without factors that can cause reflection in the body. Material types “Alodem” ® (Walloderm) are widely used in Israel and abroad. Its use allows immediate reconstruction of a fixed implant without the use of skin or temporary implants.

Defining Sentinel Nodes

It is very important to know whether cancer cells have spread to the lymph nodes, as this fact affects the recovery, as well as the treatment regimen and follow-up after surgery. The technique that enables this study is called the “lymphatic mapping technique”: the detection and removal of signaling and pathological lymph nodes during or after surgery.

If cancer cells were able to penetrate the lymphatic system, it is most likely that they first of all got to the lymph nodes, called “sentinel”, located close to the tumor, and therefore they need to be rigorously tested, which is more accurate than a cursory study of all nodes. A minimal amount of material (blue radioactive liquid) is injected around the cancerous tumor using medical equipment in the nuclear medicine department of the hospital. In this area, only stained lymphatic nodes (sentinel nodes) are removed, after which the sample is sent for pathological examination.

In cases where cancer cells are identified, it is highly likely that all other nodes in the armpits are not infiltrated and therefore will not need to be removed. Sentinel node surgery has a very low complication rate.

If metastases are found in the sentinel node, removal of other lymph nodes in the area will be considered as a further treatment. Today, there is a tendency to reduce the number of major armpit surgeries, as this does not improve the chances of recovery in a large proportion of them. The sentinel research method reduces the number of cases of all lymph nodes removal, and also reduces the number of women who may suffer from lymphatic disorders and complications accompanying this condition.

The recovery process after surgery depends on the amount of tissue removed and cancer location. Recovery after partial removal or lumpectomy is faster than after complete removal of the breast (mastectomy).

After lumpectomy surgery

Molecular analysis of the tumor after lumpectomy

After the breast tumor removal, the tissue will be sent to the Institute of Pathology for additional studies. An experienced pathologist examines the tumor under a microscope, determines its size, and also examines some of the lymph nodes affected by metastases. This test is used for defining the further treatment. The test evaluates estrogen and progestron levels to determine if hormone therapy is appropriate for the patient. The pathologist also performs a protein stain called Mount Tu (HER2) to determine if targeted therapy is appropriate.

There are also additional tests that help Israeli doctors choose the right treatment. These tests investigate the activity of a large number of genes simultaneously in cancer tumor cells and determine its molecular profile. In some cases, they help to decide whether to add chemotherapy drugs to the therapy protocol or they can be avoided, depending on the type of profile defined in the test. New complementary methods are being explored today to help develop each woman’s unique personality according to her genetic profile. These tests are used for personalized breast cancer treatment.

⇒ More detailed Oncotests for breast cancer in Israel

References: cancer.org.il