Lumpectomy with sentinel lymph node biopsy (breast cancer)

Lumpectomy, also called breast-conserving surgery, removes the tumour with a margin of healthy tissue around it while keeping the breast. It is offered whenever the size of the tumour relative to the breast allows it. It is almost always followed by radiotherapy to the breast, which is part of the treatment. The sentinel node technique allows the armpit to be assessed without removing all the lymph nodes. The sentinel node is the first node to receive lymph from the breast. It is located using a substance injected near the tumour (a radioactive tracer injected in an external nuclear medicine department, a blue dye, or both), then removed through a small incision in the armpit. Its analysis shows whether the disease has reached the lymph nodes and guides the next steps. Every case is discussed at a multidisciplinary team meeting bringing together surgeons, oncologists, radiation oncologists, radiologists and pathologists. This meeting decides the order of treatments: surgery first, or chemotherapy before surgery in some cases. When the tumour cannot be felt, it is localised by the radiologist before the operation. At Clinique Pasteur Tunis, the patient is supported at every stage, from the diagnosis to follow-up. The surgeon pays attention to the shape of the breast; reshaping techniques may be combined, in collaboration with the clinic's plastic surgeons.