Surgery unit

Surgery may be used in combination with radiotherapy or drug therapy (chemotherapy, hormone therapy and targeted therapy). The surgery department at the Eugène Marquis Centre has 12 surgeons and 13 anaesthetists, all of whom trained at establishments that are members of the Rennes Regional Cancerology Institute [Institut Régional de Cancérologie de Rennes].

BREAST-CONSERVING SURGERY

The aim of breast-conserving surgery is to remove the tumour without removing unaffected mammary glands. It is also called a tumourectomy or a partial mastectomy. The tumour, including a large surrounding margin of tissue, is removed. This safety margin is included to make sure that all of the tumour has been removed. The nipple and the areola are retained in most cases. The anatomopathologist analyses the tumour and the surrounding tissue during surgery.

ONCOPLASTY

Oncoplasty is surgery to reconstruct the breast after a tumourectomy. The aim is to make the breast look and feel more natural. During oncoplastic surgery, the breast is reshaped to fill in the gap left by a tumourectomy.

Level 1 oncoplastic surgery involves the simple reshaping of the breast, including the repositioning of the nipple and areola if required.

Level 2 oncoplastic surgery uses plastic surgery techniques.

TOTAL MASTECTOMY

A total mastectomy involves the removal of the entire mammary gland, including the areola and the nipple. It is particularly recommended where:

  • The tumour is too big compared to the size of the breast to perform breast-conserving surgery and where neoadjuvant chemotherapy or hormone therapy to shrink the tumour are not possible.
  • The shape or location of the tumour make breast-conserving surgery impossible, as too little mammary tissue would be left or as the breast would be deformed.
  • The breast contains multiple tumours.

After a total mastectomy, you may be offered an external breast prosthesis that can be slipped easily into and out of your bra. It is a foam prosthesis that can be worn during healing.

The day after surgery, a prosthetist from a specialist company will visit you in your room to offer you a temporary prosthesis that you can wear for the first month. The prosthesis is chosen to match your body.

During your post-surgery consultation, you will be given a more realistic external breast prosthesis, which is worn in a special bra. A few months later, you may be offered a self-sticking prosthesis, which attaches directly to your skin.

Social security or your insurer may cover the cost of the prosthesis.

Depending on your situation, a breast reconstruction may be performed immediately or at a later date. You can discuss this with your surgeon.

SENTINEL LYMPH NODE BIOPSY

Lymph node exeresis is surgery to remove the axillary lymph node(s) closest to the tumour to check whether it/they contain cancerous cells. Thanks to this technique, the axillary lymph nodes are removed only where it is confirmed that they contain cancer cells.

The aim of the surgery is to confirm whether the tumour has spread outside the breast and whether chemotherapy or lymph node radiotherapy is required.

AXILLARY LYMPH NODE DISSECTION

During surgery for breast cancer, it is sometimes necessary to remove a group of lymph nodes from the armpit. This is known as axillary lymph node dissection.

Axillary lymph node dissection is used for invasive cancers:

  • Where a sentinel lymph node biopsy is not possible or recommended
  • In certain cases where the sentinel lymph node contains cancerous cells (positive lymph node)

BREAST RECONSTRUCTION

Breast reconstruction is a key part of breast cancer treatment, in particular following non-breast-conserving surgery. Breast reconstruction may be performed at the same time as the surgery to remove the tumour; this is known as an immediate reconstruction. More often, the breast reconstruction is performed as a separate operation, once treatment has finished; this is known as delayed breast reconstruction or secondary reconstruction.

Breast surgeons are trained in breast reconstruction techniques and can offer complete care suited to each patient’s needs: immediate or secondary breast reconstruction, breast reconstruction using a prosthesis or autologous free flaps, additional reconstruction using lipomodelling and contralateral breast symmetrisation.

Whatever method is used, breast reconstruction usually requires two to three operations, with three to six months between each one.

  • The aim of the first operation is to reconstruct the shape and size of the breast.
  • The aim of the second operation is to make both breasts match so as to improve the overall appearance. Although not always necessary, this is a key part of breast cancer treatment.
  • The aim of the third operation, which is sometimes performed at the same time as the second, is to rebuild the areola and nipple area.

 

Each case is different and requires the right type of reconstruction (immediate or delayed, using implants or free flaps, etc.). During the consultation and after you have been examined, your surgeon will explain the most suitable technique(s) for you. You are always given time to think about the options.

Only the patient is able to decide whether or not to undergo breast reconstruction.

SKIN TUMOURS

Surgery for skin tumours covers various approaches, including exeresis, skin graft, covering with free flaps, sentinel lymph node biopsy and axillary lymph node dissection.

Our team

BAUDRY Jean-Frédéric

Dr BAUDRY Jean-Frédéric Doctor Anesthetist

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CALIPEL Séverine

Dr CALIPEL Séverine Doctor Anesthetist

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CHEVALIER Stéphanie

Dr CHEVALIER Stéphanie Anesthetist doctor

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DENOUAL Vincent

Dr DENOUAL Vincent Doctor Anesthetist

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DERIVAUX Benoît

Dr DERIVAUX Benoît Anesthetist doctor

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Dr-DESSAINT

Dr DESSAINT Adèle Senological surgeon and breast reconstruction

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DIDAILLER Jean-Louis

Dr DIDAILLER Jean-Louis Doctor Anesthetist

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Dr DUQUESNE Maud

Dr DUQUESNE Maud Senological surgeon and breast reconstruction

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Dr FOUCHER

Dr FOUCHER Fabrice Senological surgeon

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Dr GUILLERMET

Dr GUILLERMET Sophie Senological surgeon and breast reconstruction

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JOSTE Marine

Dr JOSTE Marine Senological surgeon

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LADURÉ Marie-Lorraine

Dr LADURÉ Marie-Lorraine Doctor Anesthetist

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Pr LAVOUE

Pr LAVOUÉ Vincent Senological surgeon

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LE BERRE Pierre-Yves

Dr LE BERRE Pierre-Yves Doctor Anesthetist

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LECUYER Sébastien

Dr LECUYER Sébastien Doctor Anesthetist

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Pr LEVEQUE

Pr LÉVÊQUE Jean Senological surgeon

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MEAL Cécile

Dr MEAL Cécile Plastic surgeon

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Dr MENEZ

Dr MENEZ Tiphaine Cutaneous plastic surgeon

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MOUNIER Loïc

Dr MOUNIER Loïc Doctor Anesthetist

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PIECHNO Sonia

Dr PIECHNO Sonia Doctor Anesthetist

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PONG Sarah

Dr PONG Sarah Doctor Anesthetist

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PORTE Frédéric

Dr PORTE Frédéric Doctor Anesthetist

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ROBERT Anne-Laure

Dr ROBERT Anne-Laure Senological surgeon

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ROZE Olivier

Dr ROZE Olivier Doctor Anesthetist

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SARDAIN Hugo

Dr SARDAIN Hugo Senological surgeon

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WACHOWIAK Mathieu

Dr WACHOWIAK Mathieu Doctor Anesthetist

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Dr ZAKA

Dr ZAKA-CARCAILLET Parwana Senological surgeon

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