We offer modern breast cancer care with multiprofessional experts.

Early detection, accurate diagnoses and radical surgery are the basic keys for good recovery.

We perform breast-conserving surgery, whenever possible, and offer the breast reconstruction in cases of mastectomy as a primary or secondary procedure.

With unique “sensing-breast” method we restore the sensation for the new breast after mastectomy.

With tailor made rehabilitation during and after the breast cancer treatment we support our patients to return to good quality of life.

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Diagnostics

All abnormal symptoms in breasts are worth examining.

  • All lumps
  • Retraction of breast skin
  • Blood leakage from a nipple
  • Skin change in your nipple
  • Breast inflammation (mastitis) in women who are not pregnant

All these symptoms should be examined by mammography and ultrasound.

A needle biopsy should be taken from every suspicious change in breast tissue. A biopsy can be taken with a true cut or with vacuum aspiration, guided by ultrasound, MRI or stereotacticly with mammogram.

In diagnostics, the histological analysis of the needle biopsy is important as it affects the surgeon's operation plan. It is imperative to define the size and the location of the breast tumour as the operation plan depends on these factors. The examination of the healthy breast is also carried out.

An MRI examination is needed when tumour size and location are unclear, for example in a lobular type of breast cancer, which presents itself poorly in a mammography.

Breast Cancer Surgery

 

Breast conserving surgery or mastectomy? It depends on the stage of the disease.

With plastic surgical skills (so called oncoplastic techniques) we can perform large resections for the cancer breast and remodel the breast back at the same operation. In 2017, 75% of the breast cancer procedures were performed with a breast conserving technique in the Savonlinna district.

By reducing and reshaping large breasts it is possible to successfully operate on relatively big tumor. The surgical radicality (clear margins around a tumor) is assessed by radiological and pathological examination after the operation.

Sometimes it is optimal to correct also the size of the healthy breast in order to get good symmetry with breasts, while performing radical resection and remodeling of the cancer breast in big tumors.

A breast removal (mastectomy) is necessary, when the tumor in the breast is very large in proportion to the breast size or it is multilocular. Carriers of the breast cancer gene defect will also go through mastectomy.

In mastectomy cases it is possible to spare the skin of the breast area and add an expander prothesis below the pectoral muscle. By filling the expander, the size of the breast can be restored while in cancer treatment. Depending on the size and location of a tumor, the nipple can be spared.

The final breast reconstruction will be done after the patient has recovered from her disease.

In selected cases it is possible to perform an immediate breast reconstruction during the mastectomy.

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Before oncoplastic surgery

after-surgery

And after oncoplastic surgery

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The same patient after the breast conserving oncoplastic surgery in her left breast...

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Reduction plasty to the right breast was performed as a symmetry correction

Axillary status is established by sentinel node examination

Lymph fluid drains from the breast tumor area to the axilla (armpit). The first lymph nodes in the lymph duct routes stops and eat cancer cells and they are called sentinel nodes. They are marked with isotope mapping by injecting technetium isotope into the breast tissues before the operation. The isotope is then detected during the operation using a gamma detector.

The sentinel nodes are removed during the operation. When needed, they are sent to a pathologist for a frozen section analysis. If the sentinel nodes are healthy, axillary lymph node dissection is not needed.

The evacuation of the armpit lymph nodes is done if the disease is widely found in the sentinel nodes. Prior to the operation, suspected lymph nodes are examined by ultrasound and fine needle biopsy. If the metastasis of lymph node is found, the evacuation is performed.

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Preparation of isotope Technetium for sentinel node procedure

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Postoperative patient care

Following breast cancer surgery most people go home on the second day after the operation. Most often patients go home with a drain from the operation area. The drains are removed after their outputs are under 50 ml per day. The stitches are removed 8 days after the operation.

Blood leakage after the operation is possible, but a rare complication. Most often it happens during the first postoperative day, in which case a new operation (hematoma evacuation) is needed. Treating this kind of complication is included in the price of the operation.

Infection complications are very rare. The treatment of infections in the operation area within a week from surgery is included in the price of the operation.

After the operation we recommend for a patient to stay in Savonlinna about one week.

The patient visit the out-patient policlinic as often as it is needed during her stay in Savonlinna.

We offer the tailor made rehabilitation for every one!

Oncological treatment

In certain case oncological care with chemotherapy is performed before operation, for example in cases of inflammatory breast cancer (neo-adjuvant care).

After surgical care a pathological analysis of all tissue sections is performed, and the final evaluation of the state of the disease is given.

The type and size of the tumor; the aggressiveness (gradus); cell invasion in neighboring tissue like small vessels, lymph ducts or nerves; immuno-histological receptor status (estrogen-, progesteron-, herseptin) and cell proliferation activity (Ki67) define the oncological after care.

After this, an oncologist plans so-called adjuvant care: possible cytostatic therapy, antioestrogen therapy and radiotherapy of the breast depending on the stage of the disease. All patients who undergo a breast conserving surgery in Savonlinna receive radiotherapy.

Adjuvant therapy for Patients from abroad can be perform in Savonlinna or in other hospitals in Finland.