Main indications for surgery
The performance of a sectoral resection is strictly regulated by the presence of specific pathological changes in the organ's tissues. Surgical intervention is indicated in the following cases:
- Benign tumors of the breast.
- Fibrocystic mastopathy requiring surgical treatment.
- Cysts of various sizes and locations.
- Suspicion of a malignant tumor. In this situation, the surgery is diagnostic in nature and acts as an extended surgical biopsy for subsequent histological examination.
Anesthesia methods
The choice of anesthesia method depends on the scope of the planned intervention and individual characteristics. Two main options are used:
- Local anesthesia — used for small, clearly palpable formations.
- Endotracheal anesthesia (general anesthesia) — used when the lesion is located deeper or when a wider tissue excision is required.
Surgical technique
The surgery is performed in a strict sequence to ensure radical removal of the lesion and a good aesthetic outcome.
- Surgical access (incision). The skin incision is always made radially. The incision line starts from the edge of the areola (areola) and is directed directly over the site where the pathological formation is palpated.
- Tissue mobilization. At this stage, the surgeon carefully separates the edges of the incised skin along with the subcutaneous adipose tissue, retracting them to the sides to ensure sufficient visualization.
- Wound revision. Thorough inspection and palpation are performed within the wound to accurately determine the boundaries of the pathological focus prior to its removal.
- Excision of the lesion. The surgeon excises the corresponding lobules of the breast. The most important technical rule at this stage is the need to strictly adhere to the natural interlobular boundaries of the organ.
Briefly: answers to topical questions
Why is the skin incision in breast surgery made specifically in a radial direction?
The skin incision in breast surgery is made radially. Radial incisions run from the periphery to the center and do not affect the areola, which prevents damage to the milk ducts. The excretory milk ducts converge radially toward the nipple.
Which tissue layers are sequentially incised to access the pathological focus in the breast?
To access the pathological focus, the skin, subcutaneous adipose tissue, superficial fascia, and breast tissue are sequentially passed through. The superficial fascia forms the connective tissue capsule of the gland. When excising the sector, efforts are made to adhere to the interlobular boundaries.
How is hemostasis performed and what main blood vessels can be damaged during sectoral resection?
During breast surgery, thorough bleeding control is performed. The breast is supplied with blood by branches of the internal thoracic, lateral thoracic, and intercostal arteries, as well as branches of the axillary artery. Veins accompany the arteries of the same name and form a dense network with numerous anastomoses.
What is the technique for closing the surgical wound after removing a breast sector?
After removing the sector, the cavity in the gland is eliminated by placing deep interrupted sutures. The wound is drained with a tube drain. Then, the subcutaneous tissue and skin are sutured layer by layer.
To memorize the direction of the incision: RAR — Radially from the Areola to the Wound (pathological formation).
Class and exam questions
In what direction is the skin incision made during sectoral resection?
The skin incision is made radially. It begins from the edge of the nipple-areolar complex and runs directly over the palpable pathological lesion.
What role does sectoral resection play in suspected cancer?
When a malignant tumor is suspected, this procedure is performed as a surgical biopsy method to obtain tissues and establish an accurate diagnosis.
What anatomical structures does the surgeon target when excising tissues?
When excising the affected breast lobules, the surgeon tries to adhere to the natural interlobular boundaries.
What else to study on this topic
- Anatomy and blood supply of breast lobules
- Structure of the areola
- Suture technique after lobule excision
- Features of local anesthesia in the breast
- Histological examination of tissues after biopsy
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