General Surgeon, Darwin

 

Breast and Endocrine Surgery

Breast biopsy

Several methods for a breast biopsy now exist. Fine needle aspiration (FNA) is a percutaneous ("through the skin") procedure that uses a fine needle and a syringe to sample fluid from a breast cyst or remove clusters of cells from a solid mass. A core needle biopsy is a procedure that removes small but solid samples of tissue using a hollow "core" needle. With core needle biopsy, a relatively large sample can be removed through a small single incision in the skin, giving more information about the breast disease. A core needle biopsy procedure takes a few minutes to perform and is almost painless.
Open surgical biopsy means that a large mass or lump is removed during a surgical procedure. Ten years ago, most breast biopsies were open surgical procedures. Today most patients are candidates for less invasive biopsy procedures such as core needle biopsy.

Surgery for breast abscess
A breast abscess is a collection of infection or pus that develops into the breast.  An abscess (or suspected abscess) in the breast may be treated by fine-needle aspiration (percutaneous aspiration) or by surgical incision and drainage; each of these approaches is performed under antibiotic coverage. In case of puerperal breast abscess, breastfeeding from the affected breast should be continued where possible.

 

Surgery for breast cancer

Mastectomy
Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. A mastectomy is usually carried out to treat breast cancer. In some cases, people believed to be at high risk of breast cancer have the operation prophylactically, that is, as a preventive measure. Alternatively, some patients can choose to have breast conserving surgery, where a small volume of breast tissue containing the tumour and a surrounding margin of healthy tissue is removed to conserve the breast.


Lumpectomy
Lumpectomy or wide local excision is a form of breast-conserving surgery, a less radical cancer surgery than mastectomy. Lumpectomy is a surgical removal of a discrete portion or "lump" of breast, usually in the treatment of malignant tumour or breast cancer. The amount of tissue removed is limited compared to a full-breast mastectomy, and thus may have physical and emotional advantages over more disfiguring treatment.
Both mastectomy and lumpectomy are referred to as "local therapies" for breast cancer, targeting the area of the tumour, as opposed to systemic therapies, such as chemotherapy, hormonal therapy, or immunotherapy.


Lymph Node Biopsy
In determining what additional treatments (such as chemotherapy or hormonal therapy) beyond surgery may be necessary for breast cancer, lymph node biopsy is commonly performed. For early breast cancer, sentinel lymph node biopsy may be performed, where only 1 to 3 lymph nodes under the arm are commonly removed. In axillary clearance, all the lower lymph nodes under the arm are removed. This may be necessary both to determine further treatment as well as to any control disease that may be present under the arm.

 

Endocrine Surgery

Thyroidectomy

A thyroidectomy is an operation that involves the surgical removal of all or part of the thyroid gland. Surgery is performed when a patient has thyroid cancer, or some other condition of the thyroid gland, such as overactivity (hyperthyroidism) or goiter (enlargement of the thyroid giving neck swelling). Other indications for surgery include cosmetic (very enlarged thyroid), or symptoms from pressure in the neck by the thyroid, giving obstruction with difficulties in swallowing or breathing.

Parathyroidectomy

Parathyroidectomy is the surgical removal of one or more parathyroid glands. This procedure is used to remove growth or tumours or to control overactivity of the glands, when they produce excessive parathyroid hormone. Parathyroid hormone is involved in the control of calcium levels in the body. The location of the glands is generally behind the thyroid, but there is a lot of variation. The location of an enlarged gland can often be confirmed via a Nuclear Medicine (Sestamibi) scan or on Ultrasound

 

 

 

 

 

 

Mr John Treacy, General Surgery in Darwin
Darwin General Surgeon Mr John Treacy
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