Breast Cancer Center

Diagnostics

Three breast examinations are important:

• a physical examination of the breast (palpation)
• breast ultrasound (mammasonography)
• breast X-ray (mammography)

If these examinations reveal an abnormality in the breast tissue, it should be evaluated through a biopsy (tissue sample). In almost all cases, this can be done using a so-called core needle biopsy.

The clinical examination of the breast (and the armpits) consists of two parts:

Inspection

The doctor examines the breast visually to detect any changes in the skin or dimpling. The doctor will likely ask you to raise your arms, as some changes can only be detected this way.

Palpation

Palpation of the breast and armpits is used to detect changes in the tissue (so-called lumps). If you feel a lump in your breast, this does not automatically mean that you have cancer, as there are many benign lumps. A lump should always be investigated further (see Mammography/Breast Ultrasound and Biopsy).

You should also perform these self-exams regularly. Ask your gynecologist to show you what to look for. Mammography and breast ultrasound are used to further evaluate an abnormal finding detected during a self-exam. These tests can help determine whether a lump is more likely to be benign or malignant. Another use for these tests is in screening to detect potential tissue changes before they can be felt.

Mammography

A mammogram is an X-ray of the breast. It can reveal changes in breast tissue. Even the smallest changes, such as so-called “microcalcifications,” can be detected very early on. This allows the precancerous stages of breast cancer to be identified and treated.

Breast Ultrasound

Breast sonography is an ultrasound examination of the breast and the armpit. It can also visualize changes in breast tissue as well as lymph nodes in the armpit. In young women in particular, the breast tissue is very dense, making it difficult to interpret a mammogram. In such cases, ultrasound is an important diagnostic tool. Cysts in the breast can be clearly identified using ultrasound.

Surgical Treatment

Today, the majority of women with breast cancer can undergo breast-conserving surgery. During this procedure, the tumor itself, the immediate surrounding tissue, and some of the lymph nodes from the armpit are removed. Further analysis of the tumor tissue determines the likelihood of the disease recurring or of metastases developing, as well as whether systemic therapy in the form of chemotherapy or hormone therapy is necessary. 

In the case of breast-conserving surgery, follow-up radiation therapy is always required; it is less commonly needed after a mastectomy. Whether breast-conserving surgery is possible depends, among other factors, on the location and size of the tumor in relation to the size of the breast. However, if a complete mastectomy is necessary, this by no means signifies a loss of physical integrity, as the removed breast can be reconstructed. This breast reconstruction can be performed during the same surgical procedure—or at a later date. 

In recent years, plastic surgery has developed various techniques that allow for the recreation of the breast’s shape without negatively affecting the patient’s clinical course. Reconstruction is performed either by inserting silicone gel implants or non-silicone-filled prostheses, or using the patient’s own muscle and skin tissue (for more information, see here:Center for Reconstructive and Aesthetic Breast Surgery).

For some time now, new surgical techniques have been used that allow for the removal of lymph nodes in an even gentler and more targeted manner. Scientific studies have been and continue to be conducted to determine whether, in the future, it will be sufficient to remove only the first lymph nodes reached by the lymphatic drainage from the breast as representative lymph nodes. These are known as “sentinel lymph nodes.” They are marked using dye solutions or radioactive substances, which are injected into the area surrounding the tumor prior to surgery so that they can then be specifically removed during the procedure. Using imaging techniques, the lymph nodes marked in this way are removed during the same surgical procedure and examined for tumor cells. If no tumor cells are found, it should be possible in the future to avoid the routine removal of additional lymph nodes from the armpit.

Radiation Therapy

Radiationtherapy is an integral part of breast cancer treatment. It is used following breast-conserving surgery and, depending on the stage of the disease, following mastectomies to minimize the risk of local recurrence. Treatment takes place daily, usually on an outpatient basis, and lasts for a total of about five to six weeks. We collaborate with all radiation oncology centers in the area, ensuring that this necessary treatment can be provided close to home.

The goal of treatment is to achieve high efficacy while sparing healthy tissue as much as possible. Protecting the skin and ensuring a good cosmetic outcome are key considerations. Radiation is delivered using a linear accelerator that emits so-called ultra-hard X-rays. At the start of therapy, an optimal dose distribution is calculated based on physical and medical criteria, tailored to the individual body contours of each patient.

Drug Therapy

Drug-based tumor therapy encompasses all options for chemotherapy and hormone therapy. So-called high-dose chemotherapy is performed in collaboration with the Department of Internal Medicine and Polyclinic (Tumor Research). In addition, medications are used that aim to improve the quality of life for patients with advanced cancer who are undergoing chemotherapy. Innovative immunological antibody therapies designed to specifically activate the body’s own tumor defense mechanisms are also employed. The decision regarding any necessary drug therapy is made during the interdisciplinary tumor board meeting.

Clinic Hours

Breast Cancer Center (Outpatient Clinic)
Monday and Wednesday 8 a.m. to 3 p.m. or by appointment

To make an appointment, call

Phone: 06142 88-1316

Email: brustkrebszentrum@~@gp-ruesselsheim.de