Innovationen in der Brustchirurgie: Zielgerichtetes Operieren und Minimierung von Nebenwirkungen

The S3 guidelines and evidence-based recommendations of the specialist societies are fundamental for the decision-making processes in breast cancer patients. Furthermore, a multitude of new technical possibilities and materials allow improvements in the diagnostics and treatment of breast cancer patients. Special attention is paid to the avoidance of overtreatment, particularly in the axilla. In the INSEMA trial patients with one or two affected sentinel lymph nodes (SLN) and originally negative axilla were tested whether a further completion of axillary dissection was necessary. A critical issue remains the low sensitivity and specificity of clinical and imaging diagnostics of the axillary nodal status. Against this background the SentiGuide study is analyzing the benefits of 3D navigated and ultrasound-guided minimally invasive diagnostics of SLN. Further aspects discussed in this article are minimization of seroma-induced complications in radical breast surgery by using a surgical adhesive and the minimization of wound healing complications by using low pressure vacuum compression dressings.